Anaphylactic shock

Anaphylactic shock (AS) is one of the most dangerous complications of drug therapy classified as Ig-E mediated Immune response. The average overall prevalence of AS is 80–120 cases per million person-years, and the total mortality reaches 1% (the mortality rate of 1–5.5 per million populations per year). Causes of anaphylactic shock include drugs (contrast, antibiotics (cephalosporin, carbapanems and penicillin), local anesthesia etc.) food, venom from insect bites. (В et al., 2020).

Depending with the severity of anaphylactic shock symptoms may range from uticaria,pallor, erythema angioedema nausea, vomiting, and hypotension (60/40 mmHg),tachycardia. bronchospasm. (Santimaleeworagun, Pattharachayakul, & Chusri, 2016). The key difference between anaphylaxis and anaphylactic shock is the presence of severe tissue hypoperfusion in shock state which may progress into a failure of vital organs (Malsy, Leberle, Ehehalt, Sinner, & Hobbhahn, 2015).

The aim of management of anaphylaxis is the restoration of oxygenation and perfusion of the brain along with the reversal of pathological changes. Nurses, as a key member of the health team, must be focus on airway, breathing, and circulation, as well as adequacy of mentation. Immediately stop contact with the allergen, place the patient in recumbent position with the lower extremities elevated to maximize perfusion of vital organs, prevent severe hypotension, subsequent inadequate cardiac filling, and pulseless cardiac activity. Insert two large bore IV catheters for rapid administration of fluids and medications. In normotensive adults, isotonic (0.9%) saline should be infused at a rate of 125 mL/hour to maintain venous access, administer oxygen 70-100 percent/ 15 liters per minute flow rate. Initiate continuous electronic monitoring of cardiopulmonary status, plus vital signs including oxygen saturation by pulse oximetry, is required for the duration of the episode. According to physician order, Epinephrine should be injected intramuscularly, If symptoms are severe, an IV epinephrine infusion should be administered. Anaphylactic Shock is reversible, but must be recognized and treated immediately to prevent irreversible organ dysfunction (Nikpeyma, 2018).