What is the first-line drug for resuscitating patients with anaphylactic shock?
Apr 14, 2019
Source: Cainiu Health
Dr. Shen Yonghua
Introduction
In anaphylactic shock, epinephrine 0.5 mg should be administered immediately via subcutaneous or intravenous injection. Glucocorticoids, antihistamines, rapid fluid resuscitation, and supplemental oxygen are critical components of initial management. If cardiac arrest occurs, the dose of epinephrine should be increased, and cardiopulmonary resuscitation (CPR) should be initiated. Early endotracheal intubation or tracheostomy is required to relieve upper airway obstruction.
Anaphylactic shock is characterized by an IgE-mediated hypersensitivity reaction, often involving multi-organ injury. Clinically, it frequently occurs during drug administration and is marked by the sudden onset of chills, high fever, and other symptoms that are disproportionate in severity.
Upon recognition of anaphylactic shock, the offending drug infusion must be immediately discontinued, and epinephrine 0.5 mg should be administered subcutaneously or intravenously. Initial management critically includes glucocorticoids, antihistamines, rapid fluid resuscitation, and supplemental oxygen.
If cardiac arrest occurs secondary to the allergic reaction, epinephrine dosage should be rapidly escalated, and cardiopulmonary resuscitation (CPR) initiated promptly.
For patients presenting with hoarseness, tongue swelling, or pharyngeal/laryngeal edema, early endotracheal intubation or tracheostomy is recommended to relieve upper airway obstruction and ensure airway patency.
