What is the most important step a nurse can take to prevent anaphylactic shock?
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Anaphylaxis is a serious allergic reaction, which is distressing and frightening for anybody affected. Episodes occur with variable degrees of severity, but in the most severe cases can result in death. It is essential that clinicians can recognise symptoms early and respond quickly, and take appropriate steps to ensure the affected person makes a full recovery. This article therefore hopes to give an overview of recognition, causes, treatment and management and ensure that nurses have greater confidence in dealing with this urgent situation should they encounter it. Prevalence The problem can affect any one and at any age and can potentially be problematic in both men and women. The incidence in the UK is estimated to be about 1-3 reactions per 10,000 population per annum.1 Statistics from the US suggest that the overall frequency of episodes of anaphylaxis using current data lies between 30 and 950 cases per 100,000 persons per year.2 However, true and accurate prevalence rates are difficult to determine as milder cases may either go unrecognised or be attributed to another cause therefore resulting in misdiagnosis. Pathophysiology
Anaphylaxis is a medical emergency that requires immediate treatment. If someone has symptoms of anaphylaxis: If you're having an anaphylactic reaction, you can follow these steps yourself if you feel able to. People with potentially serious allergies are often prescribed adrenaline auto-injectors to carry at all times. These
can help stop an anaphylactic reaction becoming life threatening. They should be used as soon as a serious reaction is suspected, either by the person experiencing anaphylaxis or someone helping them. Make sure you're aware how to use your type of auto-injector correctly. And, carry 2 of them with you at all times. There are 3 main types of adrenaline auto-injector, which are used in slightly different ways. These are:
Instructions are also included on the side of each injector if you forget how to use it or someone else needs to give you the injection. Positioning and resuscitationSomeone experiencing anaphylaxis should be placed in the correct position:
If the person's breathing or heart stops, cardiopulmonary resuscitation (CPR) should be performed immediately. In hospitalYou will need to go to hospital for observation – usually for 6-12 hours – as the symptoms can occasionally return during this period. While in hospital:
You should be able to go home when the symptoms are under control and it's thought they will not return quickly. This will usually be after a few hours, but may be longer if the reaction was severe. You may be asked to take antihistamines (an anti-allergy medicine) and steroid tablets for a few days after leaving hospital to help stop your symptoms returning. You will also probably be asked to attend a follow-up appointment with an allergy specialist so you can be given advice about how you can avoid further episodes of anaphylaxis. Adrenaline auto-injectors may be provided for emergency use between leaving hospital and attending the follow-up appointment. Page last reviewed: 29 November 2019 What is the best way to prevent anaphylaxis?The best way to prevent anaphylaxis is to stay away from substances that cause this severe reaction. Also: Wear a medical alert necklace or bracelet to indicate you have an allergy to specific drugs or other substances. Keep an emergency kit with prescribed medications available at all times.
Which is the highest priority nursing intervention for the patient who is having an anaphylactic reaction?Death from anaphylaxis may occur as a result of severe respiratory complications, cardiovascular collapse, or both. Early administration of intramuscular (IM) Epinephrine is first line treatment for anaphylaxis to prevent death and there is no known equivalent substitute.
What are the appropriate steps to manage an anaphylactic reaction?If anaphylaxis is suspected, take the following steps:. Rapidly assess airway, breathing, circulation, and mentation (mental activity).. Call for emergency medical services (EMS).. Place the patient in a supine position (face up), with feet elevated, unless upper airway obstruction is present, or the patient is vomiting.. Which action will the nurse perform first for a client in anaphylaxis to prevent harm?The FIRST step the nurse should take is to immediately remove the allergen. This would be stopping the medication, and then call a rapid response. The nurse should maintain the airway and start CPR (if needed) until help arrives.
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