anaphylactic shock -

distributive shock

type I hypersensitivity reaction

sensitisation phase
allergenencountered
->

no clinical symptoms yet

pembentukan IgE

effector phase -
> :katan allergen.IgEdi sel most

clinical symptoms start to occur ↓

histamine
widespread degranulation & release

inflammatory
-> bronchospasm

- 11 -
vasodilation

↑ capillary permeability - redem

non IgE mediated immunologic mechanism anaphylactoid reaction

·
complementsystem activation Canaphylatoxins, (3a, (5a)

·contact & coagulation system

196 mediatedanaphylaxis
 presentation:
·
airway -

stridor, hoarse voice, dysphagia

·

breathing -

respiratory distress, dyspnea, wheezing, cyanosis

· circulation -

pale, clammy, light headed, tachycardia, hypotension

·
disability -

confusion, agitation, loss of consciousness

· -
exposure urticaria, angioedema

teStS:CBC sur & electrolytes

ABC most cell tryptase

↳3 samples:asap, after 1.2 hours, after 24 hours

anesthetic or venom-relatedanaphylaxis may rate vomiting as a more concerning symptoms

initial management
-
remove allergen if possible

- lie patientflat & raise their legs

cent
- adrenalin in 1.5' if no/min response to previous close [ Adrenalin indiberikandibowahsuper I
Adult & child <12 90 500 mcg /0.5xC

child

child
6-12

< 6
go

yo
300

150
mcg

mcg
10.3

/ xc
0.15
(C

3 of 1:1000

·
px on &-blocker may exhibit an attenuated response to adrenaling

consider giving glucagon 1.2 mg in 1 in

ABC ->maintain a patent airway

SaO2 94-98% -
w/ high flow Oz

obtain in access & take bloodsamples-w/ large bore cannula 14/16 G

if
· there is impending airway compromise, give nebulizedadrenaline 9.20'

iVfluidchallengewas anda t
· 500-1000

present,
child 10 ac/kgBB
bolus

/ slow in- rapid in administration may cause hypotension

-

chlorphenamine in

adult & child >12 yo 10 mg

child 6-12 go 5 mg
↓> diphenhydramine | mg/kg/dosis
child 9.4.6h
6mo-6 you mg
2.5

child < 6 mo 0.25 mg / kgBB

-hydrocortisone in I slow is

adult & child >12 yo 200 mg ↓) methylprednisolone in Img/kg

child 6-12 100 mg ↓> dexamethasone in 5-10 mg

go

child 6mo-6 you 50 mg

child < 6 mo 25 my
· considerednebulizedsalbutamol 5 mg and/or ipratropium bromide 0.5 mg

wheezing
if occurs 9.20'
further management

for at least hours transfer to healthcare

-observe 6 -
a setting

-provide three days prescription of oral steroid and antihistamine

-beware biphasic reactions

- evaluate the It's BP, H1, perfusion, respiratory, and mental status

~refer to an allergy/immunology specialist

misc:adrenalin dose 0.01 mg/kgBB maX dose 0.5 mg in adults

0.3 mg in children
1:1000:Img/mL

1:10000 0.1
=

mg / m) or 1mg /10 mL
edukasi pada post
pX shock anafilalis:

·
Kenali & hindarialergen

perhatikan diet jenismakanan of identifikasialergen (dan Kemungkinan alsigen lain)

·

tampa gx. Jalan nafas trendelenburg

->

Ign gx. Jalan nafag to senyamanaya

ibu hamil -> miring kin

sedia autoinjector epinefrin