Adverse reactions of the anaphylactic type are rare. They appear during the first 20 minutes after the test. For conducting diagnostic tests, a specific outpatient clinic should have the medicines and the means necessary to stop acute anaphylactic conditions, as well as qualified medical personnel. After setting the skin test, patients should be under medical supervision for at least 30 minutes.
Assisting with general reactions and anaphylactic shock
In the event that after the introduction of the allergen the patient develops general weakness or agitation, anxiety, a feeling of fever throughout the body, redness of the face, rash, cough, shortness of breath, abdominal pain, the following measures should be taken:
First aid first aid
1.Immediately stop the introduction of the allergen, lay the patient (head below the legs), turn his head to the side, push the lower jaw, remove the removable dentures.
2. Apply a tourniquet above the injection site for 25 minutes.
3. Finish the injection site with 0.3-0.5 ml of 0.1% solution of adrenaline with 4.5 ml of 0.9% sodium chloride solution.
4. In the limb free from the tourniquet, add 0.3-0.5 ml of a 0.1% solution of epinephrine n / c or IM.
5. Place ice or a bubble with cold water on the injection site for 10-15 minutes.
6. Call a physician immediately.
First medical aid
If 1-5 items are executed and the effect is absent, you should:
1. Enter 0.3-0.5 ml of a 0.1% solution of epinephrine subcutaneously at intervals of 5-10 minutes. The multiplicity and dose of adrenaline administered depend on the severity of the reaction and the indices of blood pressure. In severe anaphylactic shock, the adrenaline solution must be administered intravenously in 20 ml of a 40% solution of glucose. The total dose of epinephrine should not exceed 2 ml. It should be remembered that repeated administration of small doses of epinephrine is more effective than a single dose of a large dose.
2. If blood pressure does not stabilize, intravenous drip of norepinephrine (or mezatonum) 0.2-1.0-2.0 ml per 500 ml of 5% glucose solution should be urgently started.
3.Intramuscularly or intravenously, inject glucocorticosteroid drugs: prednisolone 60-120 mg, dexamethasone 8-16 mg or hydrocortisone succinate or hemisuccinate 125-250 mg.
4. Intramuscularly introduce 2 ml of 0.1% solution of Tavegil or 2.5% solution of suprastin.
5. With bronhospazme 10.0 ml of a 2.4% solution of euphyllin is intravenously injected on a 0.9% solution of sodium chloride.
6. Cardiac glycosides, respiratory analeptics (strophanthine, korglikon, kordiamin) are introduced according to the indications.
7. If necessary, suck off mucus from the respiratory tract, vomit and perform oxygen therapy.
8. All patients with anaphylactic shock should be hospitalized. Transportation of patients, is carried out after, removal from a threatening state or resuscitation team, tk. in the course of evacuation, a repeated drop in blood pressure and the development of collapse are possible.
Doses of injectable drugs and tactics of the doctor are determined by the clinical picture, but in all cases, first of all, the introduction of adrenaline, glucocorticoids, antihistamines is necessary.
The introduction of antihistamine preparations phenothiazine series (pifolen, diprazine, etc.) and calcium preparations is not recommended.