ANAPHYLACTIC SHOCK

Date Published: 17th Jun 2019

This is a severe allergic reaction affecting the whole body. It may develop within seconds or minutes of contact with a trigger and is potentially fatal. In an anaphylactic reaction, chemicals are released into the blood that widen (dilate) blood vessels. This causes blood pressure to fall and air passages to narrow (constrict), resulting in breathing difficulties. In addition, the tongue and throat can swell, obstructing the airway. The amount of oxygen reaching the vital organs can be severely reduced, causing hypoxia.

A casualty with anaphylactic shock needs emergency treatment with an injection of adrenaline.

Common triggers:

• Foods including nuts, shellfish/fish, eggs, milk and some fruits
• Insect stings particularly wasp and bee stings
• Latex – a type of rubber found in some rubber gloves and condoms
• Medicines – including some antibiotics and non-steroidal anti-inflammatory drugs

Recognition:

• Difficulty breathing, ranging from a tight chest to severe difficulty, causing the casualty to wheeze and gasp for air
• Visible swelling of the tongue and throat with puffiness around the eyes
• Feeling of terror
• Confusion and agitation/anxiety
• Signs of shock, including lightheaded, faint and/or pale/flushed skin leading to collapse and loss of consciousness.

There may be other allergy symptoms:

• Red, itchy rash or raised areas of skin
• Red itchy, watery eyes
• Swelling of hands, feet and/or face
• Abdominal pain, vomiting and diarrhoea

What to do if someone has anaphylaxis:

A casualty with anaphylactic shock needs emergency treatment with an injection of adrenaline (epinephrine).

Call 999/112 for emergency help. Tell the ambulance control that you suspect anaphylaxis.

 Check whether the casualty is carrying any medication – an auto-injector of adrenaline and help them to use it. If the casualty is unable to administer it, and you have been trained to use an auto-injector, you may give it to him/her. Pull the safety cap off and holding the injector with your fist, place the tip firmly against the casualty’s thigh to release the medication (it can be delivered through clothing).

Remove any trigger if possible – for example, carefully remove any wasp or bee sting stuck in the skin

Help the casualty to sit up in the position that best relieves any breathing difficulty. If the casualty becomes pale with a weak pulse, help them to lie down with legs raised and treat for shock.

Monitor and record vital signs – level of response, breathing and pulse while waiting for the ambulance to arrive. If the casualty loses consciousness, open the airway and check breathing.

Repeated doses of adrenaline can be given at 5-15 minute intervals if there is no improvement or the symptoms return.

CAUTION: If a pregnant casualty needs to lie down, lean her towards her left side to prevent her baby restricting blood flow back to the heart.

You can learn more about this on all our First Aid at Work at SCQF Level 6 courses, get in touch for more details.