NURSING EDUCATION

1. ANAPHYLAXIS

2. INTRODUCTION
Anaphylaxis is a severe, life-threatening allergic
reaction occurring within seconds or minutes of
exposure to some allergents to, such as peanuts or
bee stings. It causes the immune system to release a
flood of chemicals that can cause shock, blood
pressure drops suddenly and the airways narrow and
can cause breathing difficulty .

3. DEFINITION
Anaphylaxis is a clinical response to an immediate (Type 1
hypersensitivity ) immunologic reaction between a specific
antigen and an antibody. The reaction results from a rapid
release of IgE – mediated chemicals, which can induce a severe
life threatening reaction.

4. CAUSES
• FOODS
Peanuts, walnuts, cashews, shell fish (eg : shrimp,
lobster,crab ),fish ,milk ,egg,soy,wheat,beans.

5. MEDICATIONS
Antibiotics especially penicillin and sulfa antibiotics, allopurinol,
radiocontrast agents, anesthetic agents, vaccines, hormones (
insulin, vasopressin, adrenocorticotropic hormone), aspirin,
NSAIDs.

6. INSECT STINGS
Bee venom, antivenom, cockroach calyx, dust mites, wasps,
hornets, mold spores, animal hair

7. LATEX
medical and non medical products containing latex
OTHER PHARMACEUTICAL OR BIOLOGIC
AGENTS
Animal serums, (tetanus antitoxin, snake venom
antitoxin, rabies antitoxin), antigens used in skin
testing

8. IMMEDIATE CLINICAL FEATURES
Hives and itching
Peripheral tingling and sensation of warmth

9. Pale or flushed skin
Nasal congestion, cough and wheezing
Abdominal cramping, nausea, vomiting diarrhea in case of food
allergy

10. Laryngospasm
Dizziness
Weak pulse , hypotension

11. IMMEDIATE MANAGEMENT
History collection regarding the causes of reaction
Monitor pulse, oxygen saturation and blood pressure
Monitor ECG for any cardiac abnormality
Administration of IV fluids (normal saline 1-2 L )
Oxygen administration

12. Loosen tight clothing and cover the person with a blanket.
Don't give the person anything to drink.
If there's vomiting or bleeding from the mouth, turn the person
to the side to prevent choking.
Placement of the patient in the supine position with the lower
extremities elevated,
If there are no signs of breathing, coughing or movement,
begin CPR
Intubation should be performed on an emergency basis if
stridor or respiratory distress due to upper airway compromise
is present.

13. EMERGENCY MEDICATIONS
Epinephrine
Hydrocortisone
Albuterol
Diphenhydramine

14. EPINEPHRINE
• Normal adult dose: 50 to 100 mcg (equal to 0.05 to 0.1 mg)
• Route: IV / IM
• Mechanism of action: It decreases mediator release from
mast cells, prevents or reverses obstruction to airflow in the
upper and lower respiratory tracts, and prevents or reverses
cardiovascular collapse .

15. HYDROCORTISONE
• Normal adult dose :20 to 240 milligrams (mg)
• Route :Intravenous / Intramuscular
• Mechanism of action : Inhibits accumulation of inflammatory
cells at inflammation sites, phagocytosis, lysosomal enzyme
release and synthesis, and release of mediators of
inflammation.

16. ALBUTEROL
• Normal adult dose :1 puff
• Route :Inhalation
• Mechanism of action: Acts on beta 2 adrenergic receptors ,
including bronchial smooth muscles relaxations and inhibiting
immediate hypersensitivity mediator release , particularly from
mast cells

17. DIPHENHYDRAMINE
• Normal adult dose : 10 – 50 mg
• Route : IV/IM
• Mechanism of action: Acts as an inverse agonist at the H1
receptor, thereby reversing the effects of histamine on
capillaries, reducing allergic reaction symptoms.