Anaphylaxis is a serious allergic reaction that can affect multiple organ systems and be life-threatening. Common causes include foods, medications, insect stings, and latex. Symptoms may include low blood pressure, difficulty breathing, and skin issues like hives or swelling. Treatment depends on severity but may involve epinephrine, antihistamines, corticosteroids, IV fluids, and monitoring for several hours. Prevention involves strict avoidance of known allergens and carrying emergency medication like epinephrine. Septicemia is a serious bloodstream infection caused when bacteria from another infection spread through the bloodstream. Common sources are respiratory, skin, gastrointestinal, or urinary infections. Symptoms can include fever

1. ANAPHYLAXIS
AND SEPTICEMIA
THANUJA ELEENA MATHEW

3. INTRODUCTION
Anaphylaxis is a serious allergic reaction that happens quickly and can lead to
potentially life-threatening problems with breathing or blood circulation. It is a
life-threatening syndrome triggered by a wide range of antigens and involving
multiple organ systems. Well-known causes of anaphylaxis include food (for
example, nuts) and insect venom. Allergic reactions to drugs or, less commonly,
latex may also result in anaphylaxis.

4. DEFINITION
• Anaphylaxis is a clinical response to an immediate (Type I hypersensitivity)
immunologic reaction between a specific antigen and antibody.
• The reaction results from IgE antibody. An anaphylactic reaction can be
triggered by exposure to an antigen through inhalation injection, ingestion or
skin contact. It is a severe life-threatening reaction.

5. Common Causes of anaphylaxis
• 1. Foods
• Pea nuts, tree nuts, Shellfish, fish, milk, eggs, soy, wheat
• 2. Medications
• Antibiotics, especially penicillin and sulfa antibiotics, allopurinol, radio contrast
agents, anaesthetic agents, vaccine, hormones (insulin, vasopressin, ACTH) ,
aspirin, no steroidal anti-inflammatory drugs( NSAIDS)

6. • 3. Other pharmaceutical/biologic agents
• Animal serums (Tetanus anti toxin, snake venom antitoxin, rabies antitoxin),
antigens used in skin test.
• 4. Insect stings
• Bees, wasps, horn nets, yellow jackets, ants including fire ants
• 5. Latex
• Medical and non-medical products containing latex.

11. MANAGEMENT
Management depends on the severity of the reaction.
• If the patient is in cardiac arrest, CPR is instituted. Oxygen is provided in high
concentrations during CPR or when the patient is cyanotic, dyspneic, or
wheezing.
• Epinephrine in a 1:1000 dilution is administered subcutaneously in the upper
extremity or thigh may be followed by a continuous intravenous infusion.
• Antihistamines and corticosteroids may also be given to prevent recurrences of
the reaction and to treat angioedema and urticaria.

12. • To maintain blood pressure and normal hemodynamic status, IV fluids, and
vasopressin agents are given.
• If the patient with episodes of bronchospasm or a history of bronchial asthma
or COPD, Aminophylline and corticosteroids may also be administered to
improve airway patency and function.
• If hypotension is unresponsive to vasopressors, intravenous glucagon may be
given for its acute inotropic and chronotropic effects. Patients with severe
reactions are observed closely for 12 to 14 hours.

13. NURSING MANAGEMENT
• Check any sign and symptoms for anaphylaxis.
• The nurse assesses the airway breathing pattern and other vital signs.
• The patient is observed for increased edema and respiratory distress.
• The nurse documents the interventions used and the patient’s response to treatment,
vital signs and laboratory values.
• Explain the patient of what occurred and instruction about avoiding future exposure to
antigens and administering emergency medications to treat anaphylaxis.
• Instructed about antigens that should be avoided and about other strategies to prevent
recurrence of anaphylaxis.

14. PREVENTION
• Strict avoidance of potential allergens is an important preventive measure for the patient at
risk for anaphylaxis. Patients at risk for anaphylaxis from insect’s stings should avoid areas
populated by insects.
• People sensate to insect bites and stings, those who have experience food or medication
reaction or those who have experience idiopathic or exercise induce anaphylactic reaction
should always carry an emergency kit that contain epinephrine.
• Screening for allergies before a medication is prescribed or first administered is an important
preventive measure.
• Person predisposes to anaphylaxis should wear some form of identification such as a medical
alert bracelet naming allergy to medication, food and other substances

15. ANAPHYLACTOID(ANAPHYLAXIS-LIKE) REACTION
Closely related to anaphylaxis is an anaphylactic reaction, caused by the release
of mast cell and basophil mediators triggered by non-IgE mediated events.
An anaphylactic reaction may occur with medications, food, exercise and
cytotoxic antibody transfusions. The reaction may be local or systemic. Local
reactions usually involve urticaria and angioedema at the site of the antigen
exposure. Although possibly severe, anaphylactic reactions are rarely fatal.
Systemic reactions occur within about 30 minutes of exposure involving
cardiovascular, respiratory, gastrointestinal, and integumentary organ systems.

16. SEPTICEMIA

17. INTRODUCTION
Septicemia, sometimes referred to as a medical condition that is caused by
bacteria that is known as spectcemia or bacteraemia. These bacteria affect the
bodily functions of the blood as it is responsible for the carrying of oxygen,
nutrients to your cells and it also carries waste and carbon dioxide. The human
blood is also responsible for carrying important antibodies this makes it
vulnerable to bacterial infections which get into the bloodstream and spread the
infection rapidly. This infection is usually called Sepsis.

18. DEFINITION
• Systemic illness with toxicity due to invasion of the bloodstream by virulent
bacteria coming from a local site of infection. Also known as blood poisoning.
• It is also known as sepsis, is a life-threatening complication that can happen
when bacteria from another infection enter the blood and spread throughout the
body.

19. INCIDENCE
• In the United States (U.S.), over 1.5 million people develop sepsis every year,
and around 250,000 will die from it.

20. SITE OF INFECTION
Respiratory system
Skin
Gastrointestinal system
Genitourinary system.
Bacteria Involved
Bacteria usually spill over from the primary infection site into the blood and are carried
throughout the body thereby spreading infection to various systems of the body.
E. coli
Streptococcus pneumoniae
Salmonella
Haemophilus influenzae
Type B, Listeria monocytogenes
Neisseria meningitidis
Group B streptococcus (GBS)

21. TYPES:
Postoperative septicemia
Bacterial septicemia
Meningococcal septicemia

22. POSTOPERATIVE SEPTICEMIA
• Hospital errors can unfortunately occur at any stage in a patient’s stay. One area
where many patients are the victims of doctor or hospital staff error is in the
area of postoperative infection or sepsis. These infections can be caused by
several sources including:
 Failure to sterilize surgical site
 Failure to administer pre-operative antibiotics
• Failure to use sterile instruments during surgery

23. BACTERIAL SEPTICEMIA
• Septicemia is a serious bloodstream infection.
• It’s also known as bacteraemia, or blood poisoning.
• Septicemia occurs when a bacterial infection elsewhere in the body,
such as in the lungs or skin, enters the bloodstream. This is
dangerous because the bacteria and their toxins can be carried
through the bloodstream to entire body.

24. MENINGOCOCCAL SEPTICEMIA
• Meningococcal septicaemia is an acute infection of the
bloodstream and subsequent vasculitis (inflammation of the
blood vessels) with the bacteria Neisseria meningitidis.
Neisseria meningitidis frequently lives in the upper respiratory
tract with no evidence of illness.

25. RISK FACTORS
weakened immune system, conditions such as HIV or AIDS, cancer, and cancer
therapy
chronic illness, such as diabetes, lung disease, and kidney disease
being aged under 1 year or over 65 years
recent surgery or a transplant
experiencing severe burns or other physical trauma
The infections that most commonly lead to sepsis are pneumonia, followed
by urinary tract infections (UTIs), gastrointestinal (GI) infections, and skin or
soft tissue infections.

26. CAUSES
↣urinary tract infections
↣lung infections, such as pneumonia
↣kidney infections
↣infections in the abdominal area
↣have severe wounds or burns
↣are very young or very old
↣have a compromised immune system
↣have a urinary or intravenous catheter
↣are on mechanical ventilation

27. CLINICAL MANIFESTATION
 Early signs of sepsis:
o fever, shivering, or feeling cold
o fast heart rate
o fast breathing and shortness of breath
o sweaty or clammy skin
o changes in mental state, such as feeling sleepy, confused, or losing interest
 Symptoms of septic shock:
o feeling dizzy or faint
o being confused or losing alertness

28. o slurred speech
o diarrhoea, nausea, or vomiting
o severe muscle pain and extreme overall discomfort
o difficulty breathing
o passing very little urine
o cold, clammy, and pale or mottled skin
o cold and pale or unusually warm extremities
o loss of consciousness

29. DIAGNOSTIC EVALUATION
Urine analysis
wound secretions and skin sores
respiratory secretions
blood culture
Renal function
LFTs
Blood Glucose
Clotting screen, including D-dimer and fibrinogen testing

30. Radiology - including CXR, abdominal u/s, CT, ultra sound
Measures of serum lactate
Arterial blood gases
invasive investigations: lumbar puncture, bronchoscopy, laparoscopy, lymph
node biopsy, etc.

31. TREATMENT
↣Emergency treatment involves giving antibiotics and fluids and protecting the
organs by supporting vital functions, such as breathing.
↣Hospitalization
↣Antibiotics: Clindamycin Ofloxacin Ampicillin Amoxicillin. etc.
↣Oxygen Therapy
↣Intensive care Supportive therapy
↣remove infected tissue, draining an abscess, or taking away possibly infected
foreign materials, such as catheters.

32. ↣Supportive care
↣Resuscitation
↣Intravenous rehydration
↣Intravenous hydrocortisone
↣ Intravenous antimicrobials
↣Vasopressin
↣Inotrope such as dobutamine if cardiac dysfunction occurs.

33. ↣Surgery e.g., wound debridement, abscess drainage
↣Other measures
• Nutritional supplementation
• Prophylactic heparinization
• Erythrocyte transfusion – When Hb <7 g/dl
↣ Other measures:
• Bicarbonate
• Fresh frozen plasma and platelets
• Ventilator support
• Haemodialysis or hemofiltration

34. PREVENTION
↣vaccination against infections, such as the flu and pneumonia
↣practicing good hygiene, including regular hand-washing and bathing, and
keeping any cuts and scrapes clean
↣being aware of the risk and the signs and symptoms of sepsis
↣avoid smoking
↣avoid illegal drugs
↣eat a healthy diet and exercises
↣stay away from people who are sick

35. COMPLICATIONS
Sepsis
• Sepsis occurs when your body has a strong immune response to the infection.
This leads to widespread inflammation throughout the body. It’s called severe
sepsis if it leads to organ failure. People with chronic diseases, such as HIV or
cancer, are at a higher risk of sepsis.
• Septic shock
• It is a serious drop in blood pressure is called septic shock. Toxins released by
the bacteria in the bloodstream can cause extremely low blood flow, which may
result in organ or tissue damage. Septic shock is a medical emergency. People
with septic shock are usually cared for in a hospital’s in ICU.

36. Acute respiratory distress syndrome (ARDS)
• This is a life-threatening condition that prevents enough oxygen from reaching
your lungs and blood. It often results in some level of permanent lung damage.
It can also damage your brain, which can lead to memory problems.
Renal Complications
Oliguria
Azotaemia
Proteinuria
Nonspecific casts

37. Coagulopathy
o Thrombocytopenia
o Platelet usually very low <50,000/uL in pt with DIC
Neurological Complications
o Guillain-Barre syndrome, metabolic disturbance, toxin activity
Cardiopulmonary Complications
o Hypotension
o Decrease Myocardial function

38. CONCLUSION
As septicemia is the life-threatening infection, we should
aware of simple infections which leads to serious infection. By
observing symptoms, one can take care of infections at the
initial stage. To avoid septicemia, people should be educated
and not neglect the preventive measures of infection.

39. BIBLIOGRAPHY
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41. • NET REFERENCE
M.thehindu.com>opinion>editorial
http://www.sctimdt.ac.in>rResources
nhrc.nic.in>News
www.cgdevorg>sites
www.journals.elsevier.com>
www.health economics
www.who.int>hygiene
• JOURNAL REFERENCE
http://journals.lww.com
www.nejm.org
http://scholar.google.co.in