Lecture on Anaphylactic Shock

Introduction

• Speaker: Sarah Thread Sterner
• Topic: Anaphylactic Shock
• Context: Part of a series on shock
• Call to Action: Take the free quiz after the video

What is Anaphylactic Shock?

• Occurs due to an introduction of an allergen
• Leads to the release of histamine and other substances
• Results in decreased tissue perfusion, causing shock

Type of Shock

• Distributive Shock
  • Involves small blood vessels
  • Causes massive vasodilation and increased capillary permeability
  • Leads to fluid shift out of the intravascular space

Routes of Allergen Entry

• Injection
• Inhalation
• Oral (food or medications)
• Skin contact

Common Allergens Leading to Anaphylaxis

• Foods: Shellfish, peanuts, eggs, milk
• Medications: IV contrast, vaccines, antibiotics (penicillin)
• Insects: Bee venom
• Latex
• Physical exercise
• Idiopathic (unknown causes)

Types of Reactions Leading to Anaphylactic Shock

• Anaphylactic Reaction

  • Related to the immune system
  • Involves IgE antibodies
  • Requires prior sensitization (Type 1 hypersensitivity reaction)

• Anaphylactoid Reaction

  • Not related to IgE
  • No prior sensitization needed
  • Can occur with substances like IV contrast, NSAIDs, chemotherapy agents

Mechanism of Anaphylactic Reaction

• First exposure leads to sensitization
• IgE antibodies attach to mast cells or basophils
• Subsequent exposure causes IgE to bind with allergens, triggering release of histamine

Histamine's Role in Anaphylaxis

• Causes vasodilation and decreased blood pressure
• Increases heart rate (tachycardia)
• Increases capillary permeability, causing fluid leakage
• Leads to swelling and decreased cardiac output
• Bronchoconstriction affects breathing
• Increases gastric secretions and smooth muscle contraction

Signs and Symptoms of Anaphylactic Shock

• Respiratory: Difficulty breathing, wheezing, swelling in airways
• Cardiac: Hypotension, tachycardia, potential loss of consciousness
• GI: Vomiting, nausea, diarrhea, GI pain
• Skin: Itching, redness, swelling

Nursing Interventions and Treatments

• Preventative Measures

  • Assessing allergies on patient admission
  • Avoid known allergens

• Immediate Actions (ACT FAST)

  • A: Allergen and Airway - Remove suspected allergen, manage airway
  • C: Call for help (rapid response)
  • T: Trendelenburg position to increase venous return
  • F: First-line drug: Epinephrine for vasoconstriction and bronchodilation
  • A: Administer according to MD orders (IV fluids, albuterol, antihistamines, corticosteroids)
  • S: Stay and Monitor for biphasic anaphylaxis
  • T: Teach patients about allergen avoidance, carrying an EpiPen, and expiration management

• EpiPen Administration

  • Inject through clothes if necessary
  • Hold in place for 3 seconds; massage the site for 10 seconds post-injection
  • Call 911 after use

Conclusion

• Importance of recognizing and acting quickly in cases of anaphylactic shock
• Reinforcement of preventative measures and education for patients

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