#Anaphylactic shock

[uuuhshiny]

Vladimir Verevochkin in Survival game (Игра на выживание)

After being repeatedly hit in the head (I will come to that later) he needs some stiches

[one-time-i-dreamt]

I was scrolling through TikTok and the newest trend was people making cooking tutorials for dishes full of stuff they were allergic to and the goal was to finish it before going into anaphylactic shock.

[cuteguywhump]

The Escape Artist (2013)

[limeskye]

[macgyvermedical]

What would have been the standard treatment for anaphylaxis in the 1950s? Was epinephrine the standard alongside anti-histamines or had that not been figured out yet?

This was a surprisingly difficult thing to figure out. It wasn't in any of my books, but I was able to find some info online.

Anaphylaxis was first described in the scientific literature in 1906. It was known very soon after this that histamine injected into animals could create an anaphylaxis-type reaction, leading to the understanding of anaphylaxis as a histamine response.

By some time in the 1920s, asthma (and somewhat later anaphylaxis) was being treated with self-injected epinephrine. Honestly I could not find why they had decided to do this, but it worked great.

The first antihistamines went on the market in 1937, and due to the understanding of anaphylaxis as a histamine problem, were probably used pretty quickly for anaphylaxis, though in the 1940s they were marketed more for prevention of anaphylaxis, not necessarily treatment.

By the late 1940s, corticosteroids were introduced and began being used for allergies, allowing anaphylaxis to be treated in much the same way it is today.

So to answer your question, by the 1950s, all three common medication classes used to treat anaphylaxis were in existence, and as far as I could find were being used almost the same way they are today.

[warmpeachxo]

Sudden feeling of about-to-pass-out

✨ Spontaneity ✨

[the-entity-down-the-street]

Can we talk more about how having severe allergies puts mortal fear into your soul at a young age?

Like "hey kid I know you're like five, but your body has a design flaw where if you eat (or sometimes even share a space with) {allergen} you essentially drown on land, and instead of water rushing into your airways, your body turns against you, tongue and throat swelling until breathing is completely cut off. You're surrounded by oxygen, yet it's completely inaccessible. Only way to *temporarily* keep that from happening is to stab yourself in the thigh with a needle full of panic chemicals. Also avoiding your allergen is mostly on you because restaurants won't think twice about frying potential allergens in the same oil as the goddamn fries (or worse, they use an oil made from your allergen), the folks bringing potluck dishes don't provide listed ingredients (and you shouldn't trust their word alone), and your allergen shows up in unexpected places because nobody thinks about this stuff if their literal life isn't on the line. Have fun with that!"

What in the Junji Ito Clive Barker David Lynch horrific fuck is this body/psychological horror shit

[emotional-moss]

vent

idk this might just be a me-and-my-surrounding-conditions thing but i really wish public food places like restaurants and whatever were more careful about allergens. cause the majority of them are! they are :) but recently i went into anaphylactic shock due to a cheesecake. and i asked the waiter multiple times as well as other staff whether it contained any of my potential allergens and they were adamant that it didn’t. guess what! it did! a distinctly nutty taste, a scratchy throat and boom next thing i know i’m in the goddamn emergency room because someone couldn’t be bothered. and i’ve seen this happen too with people who request specific orders like oat milk in their coffee or to make the meal without carrots or whatever the fuck else and sometimes the people taking their orders/preparing their food just…don’t? and it’s very scary. because yeah, some peoples’ allergies aren’t severe and yeah, i had my epipen on me, but that experience still fucking sucked!

[falseandrealultravival]

Anaphylactic shock (verse)

wasp

Early afternoon today

The bush tangled in the trees

I was mowing.

While working mindlessly

I felt a sharp pain.

The tip of my left ring finger.

It was probably a bee that stung me.

Especially common in wasps

When you get stung a second time

There is concern about anaphylactic shock.

the body's immune system overreacts

You may die from shock.

About 30 years ago,

I was being harshly baptized by wasps.

Shock death is possible even if there is a gap in time.

It has now been about 4 hours since I was stung.

Other than occasional tingling, I haven't noticed any abnormalities.

--God Saved my life?

(2019.06.08)

アナフィレクシー・ショック（韻文）

今日昼下がり

木々に絡みつくヤブガラシを

刈っていた。

無心に作業していたところ

ピキッと痛みが走った。

左手の薬指の先端。

刺したのはたぶんミツバチ。

特にスズメバチに多いが

2度目に刺されると

アナフィレクシー・ショックが心配される。

体の免疫系が過剰反応し

ショック死することがある。

私は以前３０年ほど前に

スズメバチの手荒い洗礼を受けている。

時間が開いていてもショック死はありうる。

今は刺されて４時間ほどになるが

たまにチクッとする以外特に異常は出ていない。

――命拾いか。

[filthforfriends]

Me *for years*: I know I’ve been treated for anaphylaxis yesterday but there’s still something up with my throat. If feels like swelling and I’m supposed to come back if symptoms flare back up.

ER doc: So there’s no swelling. You look just fine. I think this is just anxiety.

Me: Well it feels like there’s swelling.

Mom: you’re so dramatic I knew this was a waste of my time.

ER doc: I can prescribe you a cortisteroid.

Me: I cant take prednisone it sends me into a psychotic break which is why it wasn’t prescribed yesterday.

ER doc: Well there’s really no replacement for prednisone.

Me: Aren’t you a fucking doctor?

My allergist in November 2021: so it looks like additionally there’s something wrong with your swallow reflex that’s making the sensations of your anaphylaxis feel a lot worse. It can feel like your throat is stuck or even swelling.

Me: I’ve said this to a dozen ER doctors and they gave me Ativan.

Allergist: …sorry.

[cuteguywhump]

Anaconda (1997)

[liminalweirdo]

for someone who has never had to use this or other medical needles, can someone please give me clearer detail on how hard "slam"/"swing and push firmly" means? should it change based on clothing worn, body weight, adult, senior, or child?

Anyone can help!

(Real pen the last picture)

It is important for EVERYONE to know how to help ANYONE. Not everyone can give them selves their medicine under every circumstance. Be educated, help out.

In the last year, i have gotten about five new violent allergies from foods i used to be able to eat. Next time i eat a fruit, my throat could close. I may not be able to inject myself. My boyfriend and i played with my trainer pen for like 30 minutes. He knows how to inject it. I know how. This is important.

[permanentbottombunk]

I want to try kimchi so bad but I'm allergic to all fish, including fish sauce, which is in every single recipe and store bought ones I see

I also want those shellfish boils too! I'm going to sit outside an er and eat one of those one day. I'll being chowing down while my throat closes motherfucker.

Just me, an epipen, and 35 pounds of food I've never been able to try.

[myrawjcsmicasereports]

 Anaphylactic Shock Following Black Ant Sting: A Case Report by Deng Jingqi by Journal of Clinical Case Reports Medical Images and Health Sciences 

Abstract

We present a case of a 36-year-old male patient who developed anaphylactic shock following a black ant sting. The patient exhibited respiratory depression and subsequent respiratory arrest, which posed a diagnostic challenge. The proximity of the patient to a large comprehensive hospital facilitated timely management. However, the lack of availability of essential emergency medications, such as adrenaline, in resource-limited settings like Sierra Leone hinders prompt treatment. This case emphasizes the potential underestimation and delayed intervention in cases of anaphylactic shock caused by encounters with large ants, which are not uncommon.

Keywords: Anaphylactic shock, Black ant bite, Respiratory depression, Resource-limited settings

Introduction

Anaphylactic shock resulting from encounters with insects has been reported in various regions worldwide, including the Americas, Australia, Asia, and Europe, but limited reports exist from West Africa. This case highlights the challenges in promptly diagnosing anaphylactic shock, particularly when respiratory depression and respiratory arrest occur. The patient's proximity to a large comprehensive hospital played a crucial role in facilitating immediate medical intervention. However, the unavailability of essential emergency medications, such as adrenaline, in resource-limited settings like Sierra Leone can lead to delayed treatment. It is important to recognize that cases of anaphylactic shock caused by encounters with large ants may be underestimated and not receive timely medical attention.

Case

A 36-year-old Chinese male patient presented to the Emergency Department of Sierra Leone China Friendship Hospital at 12:47, Dec 2ed, 2022. The patient reported being bitten on the toe by a large black ant (Figure 1) around 12:00. Approximately 10 minutes after the bite, the patient collapsed and complained of dizziness and difficulty breathing. On examination, his blood pressure was 83/55 mmHg, heart rate was 90 beats per minute, and oxygen saturation was 85%. The patient appeared cyanotic, and decreased breath sounds were auscultated bilaterally in the lungs. There were no visible skin lesions at the site of the ant bite. At 13:06, the patient became confused, and his oxygen saturation further declined. By 13:15, he experienced respiratory arrest. Patient's past medical history is unremarkable and there are no known drug allergies.

Resuscitation measures were promptly initiated. At 13:00, a 500 mL Ringer's lactate solution was administered to establish intravenous access. Intravenous dexamethasone 10 mg was given at 13:10, followed by manual bag-valve-mask ventilation and intravenous (IV) administration of adrenaline 0.3 mg at 13:15. Additionally, intramuscular promethazine 12.5 mg was administered at 13:20. The maximum heart rate recorded following adrenaline administration was 180 beats per minute. By approximately 13:20, the patient regained spontaneous breathing, his complexion improved, and he regained consciousness. On reassessment, his blood pressure was 125/85 mmHg, and heart rate was 95 beats per minute. The patient remained stable and asymptomatic for one day and was subsequently discharged.

    The large ant that stung the patient.

Discussion

The patient's presentation is consistent with anaphylactic shock caused by an allergic reaction to the black ant bite. While the standard symptoms of anaphylactic shock include skin symptoms, respiratory symptoms, cardiovascular symptoms, gastrointestinal symptoms, neurological symptoms, and general symptoms, this case exhibited some atypical features. These atypical symptoms may not be immediately recognized as anaphylaxis without a high index of suspicion. In this case, the patient also reported nausea, profuse sweating, and a feeling of impending doom, which are consistent with the general symptoms of anaphylaxis. Additionally, the patient exhibited cyanotic skin, indicating compromised oxygenation, which can be observed in severe anaphylactic reactions.1

In the management of anaphylactic shock, the use of adrenaline is considered a cornerstone of treatment. Adrenaline acts as a potent vasoconstrictor, bronchodilator, and cardiac stimulant, effectively counteracting the severe systemic vasodilation, bronchoconstriction, and cardiovascular collapse associated with anaphylaxis. Intramuscular (IM) administration is the recommended initial route for adrenaline administration in the management of anaphylaxis, especially in non-hospital settings or when IV access is not readily available. The preferred site for IM injection is the mid-anterolateral aspect of the thigh.2 In this case, the decision to administer adrenaline via IM injection may have provided a faster route of delivery. At the onset of the patient's presentation, there was no initial diagnosis of anaphylactic shock, and the availability of adrenaline was not established. The subsequent administration of adrenaline via IV route resulted in an increased heart rate.

The limited resources in Sierra Leone, including the unavailability of adrenaline, further complicated the management of this case. Its absence in the hospital posed challenges in providing immediate and appropriate treatment. The use of alternative medications, such as intravenous dexamethasone and supportive measures like manual bag-valve-mask ventilation, was necessary in this situation. It is essential to increase awareness and preparedness among healthcare professionals in managing anaphylactic reactions, particularly when presented with atypical symptoms such as respiratory depression and respiratory arrest.3, 4 This case emphasizes the need for education and training to ensure early recognition and prompt management of anaphylactic shock, even in resource-limited settings.

Conclusions

This case highlights the challenges in promptly diagnosing and managing anaphylactic shock, particularly when respiratory depression and respiratory arrest occur while without skin injury or symptom. Prompt recognition and immediate medical intervention are crucial in preventing adverse outcomes. Healthcare professionals should be prepared to handle anaphylactic reactions, even in resource-limited settings, by ensuring the availability of essential emergency medications. Increased awareness and education can improve the recognition and timely treatment of anaphylactic shock caused by encounters with large ants.

Disclosure: The authors declare no conflicts of interest and received no funding for this report.

[razziecat]

Is There A Doctor On Board?!?

[todayworldnews2k21]

South Africa's Steve Irwin, Graham 'Dingo' Dinkelman, Dies After Snake Bite

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