ANAPHYLAXIS #DNB/MD LECTURES #INTERNAL MEDICINE #EMERGENCY MEDICINE

1. ANAPHYLAXIS
PRESENTER: DR.SOHAN BISWAS,
DNB JR-2
INTERNAL MEDICINE

2. • Anaphylaxis is an acute, life-threatening hypersensitivity disorder,
defined as a generalized, rapidly evolving, multi-systemic allergic
reaction.
• Without treatment, anaphylaxis is often fatal due to its rapid
progression to respiratory collapse.

6. • Anaphylaxis is most often a rapidly evolving presentation, usually
within one hour of exposure.
• Roughly half of the anaphylactic-related fatalities occur within this
first hour; therefore, the first hour after the initial symptom onset is the
most crucial for treatment.
• It is important to note that the more rapid the onset and progression of
symptoms, the more severe the disease process.
• Morbidity and mortality are most often related to loss of airway and
distributive shock.

7. Anaphylactic reactions can also present in a biphasic manner in up to
20% of cases.
Even after successful management of the initial presenting symptoms,
there can be a recurrence of symptoms peaking 8 to 11 hours after the
initial reaction, therefore the potentially fatal second reaction should not
be dismissed after treatment of the initial reaction.

23. • In adults and adolescents, 2 L of normal saline are usually administered initially;
more may be required in severe cases.
• Children should receive boluses of 10 to 20 mL per kg until hypotension is
controlled.
• Even in the presence of upper airway obstruction, placing a patient in the recumbent
position with the lower extremities raised is preferred over elevating the head of the
patient's bed, because the vascular collapse during anaphylaxis can be devastating

24. • Reaction severity is not a predictor of biphasic reactions.
• Ten hours of observation is probably adequate in most situations, but some
investigators recommend a minimum of 24 hours

25. THANK YOU