Anaphylactic Shock – Anaphylaxis Experts and Information

Anaphylactic shock is a severe reaction triggered by an allergy. The immune system reacts very strongly to the allergen within a short period of time.

The body rapidly releases large amounts of histamine, which causes the blood vessels to dilate. Blood pressure drops, and the heart rate increases to compensate for the drop in blood pressure. 

Within a very short time, this can lead to a life-threatening circulatory collapse, which, if left untreated, results in multiple organ failure. In other cases, the anaphylactic reaction causes swelling of the larynx, which blocks the airways.

A severe allergic reaction can be triggered by various allergens, such as:

• Foods (such as nuts, eggs, milk, shellfish, and fish)
• Insect venoms (such as wasps, bees, hornets, and bumblebees)
• Medications (including antibiotics, pain relievers, and iodine-containing contrast agents)
• Inhaled allergens (such as pollen, house dust, animal dander, mold)
• Cosmetics
• Natural latex

In adults, insect venoms are responsible for more than 50% of anaphylactic shock cases. In children, foods are the primary trigger of severe allergic reactions. In most cases, those affected are unaware they have an allergy. This is particularly true for allergens that people rarely come into contact with, such as medications or insect venoms.

Food allergies, such as an allergy to nuts, can be life-threatening @ Goffkein /AdobeStock

Medical professionals classify anaphylaxis into four severity levels, ranging from isolated local symptoms to a severe state of shock. The symptoms do not necessarily occur in the order described; in some cases, only a few symptoms may be present. 

Important to know: The faster an allergic reaction occurs, the faster you must act and contact a doctor!

• Grade 1: Reactions such as a rash, itching, swelling, or hives appear on various areas of the skin. The patient may also complain of dizziness or a headache.
• Grade 2: In addition to the symptoms of Grade 1, the following may occur: a drop in blood pressure, a rapid heartbeat, nausea, vomiting, or diarrhea, mild shortness of breath, hoarseness, or swelling of the body.
• Grade 3: Starting at Grade 3, there is a genuine risk to life. In addition to the previous symptoms, spasms occur in the respiratory tract: swelling of the larynx, shortness of breath, difficulty swallowing and speaking, weakness, drowsiness, and a bluish discoloration of the skin, mucous membranes, lips, and fingernails
• Grade 4: The symptoms of grades 1 through 3 lead to loss of consciousness and ultimately to respiratory and cardiovascular arrest.

There are usually a few minutes between exposure to the allergen and the onset of anaphylactic shock. It takes about 10 to 15 minutes after an insect sting and about 30 minutes or longer after ingesting an incompatible food.

If severe allergic reactions occur, you must act immediately. You should call emergency medical services as soon as symptoms reach severity level 2. Provide first aid until emergency responders arrive:

1. You should stop the exposure to the allergen (bee sting, food, or medication infusion) as quickly as possible.
2. Then, you must provide initial care to the patient. If the patient is experiencing only symptoms of shock but no breathing difficulties, place the patient in the shock position: lower the upper body and raise the legs. The goal is to prevent blood from flowing to the legs so that it remains available to the vital organs.
3. If the patient is having trouble breathing, position their upper body almost upright; if they are unconscious, place them in the recovery position.
4. Afterward, you should monitor the patient’s breathing, pulse, and blood pressure and stay by their side to reassure them.
5. If Grade 4 symptoms occur before emergency medical services arrive, artificial respiration or CPR is necessary.

Patients who are aware of their allergy can protect themselves with an emergency kit. The kit typically contains an epinephrine autoinjector, an antihistamine, and a corticosteroid. The epinephrine from the pre-filled syringe raises blood pressure within a few minutes and helps restore normal heart function. The bronchial tubes relax. This stabilizes circulation and makes breathing easier.

The antihistamine stops the allergic reaction, and the corticosteroid prevents further reactions. The medications may be available in liquid form or as tablets. Liquid formulations are preferable, as they are easier to take if there is swelling in the mouth or throat. People with asthma should also carry an emergency inhaler to open up the airways. Ask your doctor to prescribe an emergency kit. It is available at the pharmacy.

If it hasn’t already been done, the emergency physician will stop the allergen exposure and position the patient correctly. The physician will then typically administer the medications found in the emergency kit. Adrenaline is delivered more quickly into the bloodstream via an IV line. Cardiovascular function improves, and the swelling of the mucous membranes subsides.  

In addition, the doctor provides the patient with oxygen and administers a volume replacement solution to raise blood pressure again. Infusions can also ensure adequate fluid intake. An antihistamine and cortisone are used in this process. 

In the case of fourth-degree anaphylactic shock, the doctor immediately begins resuscitation. The length of the hospital stay varies depending on the severity. Monitoring for at least 24 hours is required even if the symptoms improve rapidly.

Once the patient has recovered, they should undergo an allergy test as soon as possible. This is the only way for doctors to determine the exact cause and prevent another anaphylactic shock.

The skin test is the most common method for detecting allergies @ Pixel-Shot /AdobeStock