This document discusses anaphylactic and septic shock. It defines anaphylaxis as a serious allergic reaction that causes symptoms like low blood pressure, rash, swelling of the throat or tongue. Common triggers include foods, medications, insect bites and stings. Septic shock is a type of distributive shock caused by infection that results in organ dysfunction due to inadequate blood flow. It has a high mortality rate and can be caused by infections like pneumonia or appendicitis. Diagnosis involves blood cultures, imaging and labs to check for organ damage.

1. Anaphylactic and septic
shock
MD Danish Rizvi
MSc nursing 1st year

2. DEFINITION
Anaphylaxis is a serious allergic reaction that is rapid in onset and may cause
death. It typically causes more than one of the following: an itchy rash, throat or
tongue swelling, shortness of breath, vomiting, light headedness, and low blood
pressure.

3. INCIDENCE
The number of people who get anaphylaxis is 4–100 per 100,000 persons per
year, WITH a lifetime risk of 0.05 2%. About 30% of people get more than one
attack. Exercise-induced anaphylaxis affects about 1 in 2000 young people.

4. ETIOLOGY
skin-
 Symptoms typically include generalized hives, itchiness, flushing, or swelling (angioedema) of the afflicted
tissues.
 Those with angioedema may describe a burning sensation of the skin rather than itchiness.
 Swelling of the tongue or throat occurs in up to about 20% of cases.
 Other features may include a runny nose and swelling of the conjunctiva. Tinged because of Respiratory
 lack of oxygen.
 Respiratory
 lack of oxygen. Respiratory symptoms and signs that may be present include shortness of breath, wheezes, or
stridor.
 The wheezing is typically caused by spasms of the bronchial muscles
 while stridor is related to upper airway obstruction secondary to swelling. Hoarseness, pain with swallowing,
or a cough may also occur.

5. Cardiovascular
 Coronary artery spasm may occur with subsequent myocardial infarction, dysrhythmia or
cardiac arrest.
 Those with underlying coronary disease are at greater risk of cardiac effects from
anaphylaxis
 The coronary spasm is related to the presence of histamine releasing cells in the heart.
 While a fast heart rate caused by low blood pressure is more common, a Bezold–Jarisch
reflex has been described in 10% of cases where a slow heart rate is associated with blood
pressure.

6. Other
 Gastrointestinal symptoms may include crampy abdominal pain, diarrhoea, and vomiting.
 There may be confusion, a loss of bladder control or pelvic pain similar to that of uterine
cramps.
 Dilation of blood vessels around the brain may cause headaches.
 A feeling of anxiety or of "impending doom" has also been described.

7. ETIOLOGY
anaphylaxis can occur in response to almost any foreign substance.
Common triggers include:
 Venom from or stings, foods, and insect bites medication.
 Foods are the most common trigger in children and young adults.
 medications and insect bites and stings are more common in older adults.

8. Less common causes include:
Physical factors, biological agents such as
 semen
 latex
 hormonal changes
 Food additives such as monosodium glutamate and food colours
 topical medications.

9. Classification
There are three main classifications of anaphylaxis:
 Anaphylactic shock is associated with systemic causes
vasodilation that low blood pressure.
 30% lower than the person's baseline or below standard values.
 Biphasic anaphylaxis is the recurrence of symptoms within 1–
72 hours with no further exposure to the allergen.

10. SEPTIC SHOCK

11. DEFINITION
Septic shock is a subclass of distributive shock, a condition in
which abnormal distribution of blood flow in the smallest blood
vessels results in inadequate blood supply to the body tissues,
resulting in ischemia and organ dysfunction. Septic shock refers
specifically to distributive shock due to sepsis as a result of
infection.

12. INCIDENCE
 Sepsis has a worldwide incidence of more than 20 million cases a
year, with mortality due to septic shock reaching up to 50
percent even in industrialized countries.
 According to the U.S. Centres for Disease Control, septic shock
is the thirteenth leading cause of death in the United States and
the most frequent cause of deaths in intensive care units.

13. ETIOLOGY
Septic shock is a result of a systemic response to infection or multiple
infectious causes. Sepsis may be present, but septic shock may occur
without it. The precipitating infections that may lead to septic shock if
severe enough include but are not limited to

14.  appendicitis
 bacterial
 Pneumonia
 Meningitis
 Diverticulitis
 Pyelonephritis
 Fasciitis
 pancreatitis
 ischemia.

15. secondary symptoms
infection that manifests as disruptions in
 heart rate
 Respiratory rate, temperature
 white blood cell count.
If sepsis worsens to the point of end-organ dysfunction (kidney failure, liver
dysfunction, altered mental status, or heart damage), then the condition is called
severe sepsis.

16. DIAGNOSTIC EVALUATION
 BOOL CULTURE
 CHEST X-RAY
Signs of end-organ dysfunction are present in septic shock
 KFT
 LFT
 MENTAL STATUS EXAMINATION