a anaphylaktischer shock is a rare, always however acute lebensbedohliche allergische reaction (anaphylaktisch; Anaphylaxie = allergische reaction). It is released frequently by all genes and leads to a failure of the cardiovascular system with often fatal outcome.
In the vernacular the anaphylaktische shock is rather well-known as allergische reaction.
The anaphylaktische shock is the strongest form of the allergy of the so-called Soforttyp (immediate hypersensitivity reaction) and can e.g. by insect poisons, food, infusions or medicines to be released. Several organs or the entire body are concerned.
By the far position of the blood vessels it comesa strong blood pressure drop, in addition liquid withdraws from the containers into the surrounding fabric. Due to the blood pressure drop it comes to a decreased blood circulation of vital organs.
Table of contents
usually step the anaphylaktsiche shock during or briefly after i.v. - Injection or infusion of a medicine up. Also after other parenteral medicine gifts (i.m., s.c. ; Local anaesthesia with the dentist; Contrast medium injections during Roentgen contrast investigations) this heavy allergische Sofortreaktion can occur.
Very frequently the anaphylaktische shock steps also after insect bites (wasps, bees…) up. Usually is an allergy before well-known.
The anaphylaktische shock is the highest complication of an allergy of the type 1 (e.g. Polling allergy).
Only with the development of the Penizillinsand to the increased parenteral Penizillin gifts increase anaphylaktische shock reactions arose, those up to then in this form were not at all observed and before (approx. 1950) were actually unknown.
the faster the symptoms during the injection of a medicine arise, are the lethalthe condition. In the worst case already 10 second after beginning of the injection the first symptoms arise. These are very nonspecific - e.g. nausea, cycle complaints, nausea or vomiting, dry mouth, tongue burning, visual disturbances, acute difficulty in breathing, concentration disturbances.
Also skin reactions, itching, Quaddelbildung or the training of an eyelid edema are possible - are missing because of the fast development however often also completely.
In the further process the typical symptoms of a shock arise , i.e. the pulse will flat and fast and the unconsciousness can occur.
It is important that the physician and the medical personnel on a anaphylaktischenShock is adjusted.
Not even each 10. Dentist experiences a anaphylaktischen shock in his working life with his patient. On the other hand it experiences regularly a part of the nonspecific reactions described above during the local anaesthesia. Therefore it is very difficult in the medical everyday life the occurrence of a anaphylaktischen shockto recognize in time, since it concerns usually only Synkope or psychological excitation of the patient. In principle the physician must however with each injection on a anaphylaktischen shock count. It is extremely rare, in addition, extremely lethal. Therefore an allergy anamnesis must be always raised.However this no security gives, because each allergy arises sometime for the first time.
Therefore the smallest indices should be taken seriously, and be broken off in the case of doubt the injection.
A particularly high risk for a anaphylaktischen shock exists with contrast medium injections for x-ray examinations. Therefore becomesthere also a larger requirement of the patient clearing-up posed.
therapy - immediate measures (conditions of the recommendations: 2005)
With the first signs (sweating, nausea, cyanosis)
- and Kanüle interrupt
- injection in the Vene left
- and/or. a venous entrance put
apart from other common emergency measures
- head torso low situation
- Respiratory system keep free!
medicamentous immediate measures
Epinephrin (adrenalin) i.v.
After dilution of 1 ml the commercial Epinephrin solution (1: 1.000) on 10 ml or using a Epinephrin Fertigspritze (1: 10.000) becomes first of it 1 ml (= 0.1 mgEpinephrin) under pulse and blood pressure control slowly injects (cave: Heartbeat disturbances!).
The Epinephrin gift can be repeated.
volume substitution i.v.
e.g. Plasma bungee cord (Cave! can likewise anaphylaktische reactions release.), human albumin, full electrolytic solution.
e.g. 250-1000 mg Prednisolon
(or equivalent quantity of a derivative).
The Glucocorticoid gift can be repeated.
further therapys measure e.g.
consider. artificial respiration, oxygen inhalation, Antihistaminika.
explanation to the therapy
without medical assistance can end a anaphylaktischer shock deadly. Concerned ones must immediately into a hospital. First measure with a anaphylaktischen shock is thatTo bring patient into the shock storage. So far available by the emergency surgeon strongly diluted adrenalin is squirted, which the containers narrowed and which facilitate respiration. If necessarily can with oxygen - mask a increased quantity oxygen to be supplied. Alternatively to the infusion undiluted adrenalin can over the oxygen- Mask with a so-called Vernebler in the oxygen to be atomised (Bronchiale application)
beside it is given Kortison as infusion. Additionally infusions with physiological saline solution (NaCl) or ring release (RI-NAK) for an increase of the blood pressure ensure. A hospitalization for observation is compellingly necessarily, there the symptoms if necessary. after thatFade away the medicines again to arise can.
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