ANAPHYLAXIS

Bagian Anestesi FK UNISSULA Semarang

DEFINITION
The European Academy of Allergology and
Clinical Immunology Nomenclature Committee:

ANAPHYLAXIS is a SEVERE, LIFE-

THREATENING, GENERALISED or SYSTEMIC
HYPERSENSITIVITY REACTION

RAPIDLY, LIFE-THREATENING AIRWAY AND/OR

BREATHING AND/OR CIRCULATION PROBLEMS

Usually associated with skin and mucosal change

American Heart Association:

ANAPHYLAXIS is a SEVERE, SYSTEMIC

ALLERGIC REACTION characterized by
multisystem involvement, include skin,
airway, vascular system & GI tract

The shorter the interval between exposure

& reaction, the more likely the reaction
is to be severe
PATOPHYSIOLOGY

Ig-E binds to theAntigen

activatesreceptors mast cells & basophile
histamine vasodilation, contraction
of bronchialsmooth muscles >>, leakage
of fluid from blood vessels >> and cause
heart muscle depression
ETIOLOGY
Pharmacologic agents
Antibiotic
NSAID
Contrast agents iv
Latex
Stinging insect
Hymenoptera
Bees, hornet
Foods
Peanut
Seafood
MORTALITY
Risk
factor
ATOPIC, ASTHMA

Time course for fatal reaction:

Food : 30-35 min
Insect stings : 10-15 min
i.v. drugs : 5 min
RECOGNITION
A-B-C-D-E APPROACH
AIRWAY PROBLEMS
airway swelling, hoarseness, stridor
BREATHING PROBLEMS

shortness of breath, wheeze, cyanosis

CIRCULATION PROBLEMS

signs of shocks cardiac arrest

DISABILITY PROBLEMS

anxious, confusion, agitation, loss of

consciousness
EXPOSURE PROBLEMS

urticaria, angioedem
TREATMENT
RECOGNITION Call HELP Initial
assessment ABCDE approach
ADRENALINE Follow-up
Pts positioning
Low BP flat with or without leg elevation
A-B problems sit up
Unconscious recovery position
Pregnant pt LLD to prevent caval
compression
REMOVE the trigger if possible
 Oxygen
High flow rate
Epinephrine
i.m administration
dose: 0.3-0.5 mg every 15-20 min
i.v administration
dose: 0.1 mg slowly over 5 min; infusion
1-4 mcg/min
Fluid resuscitation
Isotonic crystalloid
Antihistamine diphenhydramine 25-
50 mg
Corticosteroid
THANK YOU