The Anaphylactic Shock

Name: Joselande Lormestoire
Identification: 119-5699
Section: 003
The Anaphylactic shock
Anaphylaxis is a serious allergic reaction that is rapid in onset and may cause
death. It typically causes more than one of the following: an itchy rash, throat
or tongue swelling, shortness of breath, vomiting, light-headedness, low blood
pressure, and temporary blindness. These symptoms typically come on over
minutes to hours.
Symptoms
The first signs of an anaphylactic reaction may look like typical allergy
symptoms: a runny nose or a skin rash. But within about 30 minutes, more
serious signs appear.
There is usually more than one of these:
 Coughing; wheezing; and  Shortness of breath

pain, itching, or tightness in or trouble breathing and
your chest rapid heartbeat
 Fainting, dizziness, confusion,  Swollen or itchy lips

or weakness or tongue
 Hives; a rash; and itchy,  Swollen or itchy throat,

swollen, or red skin hoarse voice, trouble
swallowing, tightness in your
 Runny or stuffy nose
throat
and sneezing
 Vomiting, diarrhea, or cramps
 Weak pulse, paleness
Some people also remember feeling a "sense of doom” right before the attack.
As many as 1 out of every 5 people may have a second anaphylactic reaction

within 12 hours of the first. This is called a biphasic anaphylaxis.
Treatment
The primary treatment of anaphylaxis is epinephrine injection into a muscle,

intravenous fluids, and positioning the person flat. Additional doses of
epinephrine may be required. Other measures, such as antihistamines and
steroids, are complementary. Carrying an epinephrine autoinjector and
identification regarding the condition is recommended in people with a history
of anaphylaxis.
Causes
Anaphylaxis happens when you have an antibody, something that usually fights
infection that overreacts to something harmless like food. It might not happen
the first time you come in contact with the trigger, but it can develop over
time.
In children, the most common cause is food. For adults, the main cause is
medication.
Typical food triggers for children are:
 Peanuts  Eggs
 Shellfish  Soy
 Fish  Wheat
 Milk
Common food triggers for adults are:
 Shellfish  Peanut
 Tree nuts (walnuts, hazel

nuts, cashews, pistachios,
pine nuts, and almonds)
The Scombroid toxicity
Scombroid poisoning typically occurs when people eat certain fish that have
been inadequately preserved. These include the spiny-finned fish of the family
known as Scombridae. Bacteria that grow during improper storage in the dark
meat of the fish produce scombroid toxin. Scombroid is a histaminelike
chemical (see Allergic Reaction). The toxin does not affect everyone who
ingests it.
No test is 100% reliable for assessing fish for this toxin. Cooking kills the
bacteria, but toxins remain in the tissues and can be eaten.
Susceptible fish include albacore, amberjack, anchovy, Australian salmon,

bluefish, bonito, kahawai, herring, mackerel, mahi-mahi, needlefish, saury,
sardine, skipjack, wahoo, and yellow fin tuna. Affected fish may have a metallic
or peppery taste.
Scombroid Poisoning Symptoms
Symptoms of scombroid poisoning generally begin 1 hour after ingestion of the

poison and include:
 Nausea  Abdominal cramps
 Vomiting  Diarrhea
 Flushing  Headache.
Other symptoms may include:
 Itching  Fever
 Hives  Unusual heart pounding

sensation.
 Burning sensation in the
mouth
Severe reactions include:
 Dropping blood  Racing heart  Wheezing.

pressure
Scombroid Poisoning Treatment
Scombroid poisoning should be treated with diphenhydramine (Benadryl) or

hydroxyzine (Vistaril) (25-50 mg every 6 hours) and 1 cimetidine (Tagamet HB)
or famotidine (Pepcid) tablet twice a day.
The answers of the questions on page 21.
First aid for Osgood-Schlatter
The first aid for Osgood-Schlatter disease focuses on preventing symptoms and
using first aid to reduce pain when symptoms occur. Rest, decreased activity,
and other measures may reduce pain until the bone and muscles mature.
First Aid
 Cool the painful area with ice cubes or with a cold pack for 10 to 15
minutes, repeating this process several times a day. Do not place ice
directly on the skin, but wrap it in a towel.
 If the knee hurts, stop play or reduce the intensity of the training. The
injury usually heals well if the load on the knee is reduced.
 Do not treat the painful area with ultrasound, since this may affect the
growth plate.
Osgood-Schlatter disease is a common cause of knee pain in older children and
athletic adolescents. It mainly affects young athletic boys between 12 and 15
years old but can begin as early as 8 years old. It would affect nearly 20% of
athletic children, and 5 to 10% of non-athletic children. It would be bilateral in
a third of cases.
Write some advices (7). One of your partners is going to start work in the
emergency Department,
1. Everything in an emergency room moves fast, so it’s crucial that nurses

can act quickly and efficiently. Hospitals want to hire ER nurses who are
quick learners, strong multitaskers and cool under pressure.
2. Though these nurses should be ready for anything, they’re frequently
asked to treat patients who have been in accidents, suffered from a
stroke or heart attack, or gone into labor. But they also handle simpler
jobs, like switching out bed sheets and checking patients’ vitals.
3. To treat these issues, ER nurses should know how to start intravenous
lines, transfuse blood, set bones and stitch wounds. They should also
have extensive experience with and knowledge of cardiopulmonary
resuscitation and rescue breathing.
4. Like other specialties, ER nurses are in charge of assessing patients
before a doctor sees them. Since emergency nurses often work with
patients in critical condition or who are experiencing a lot of pain,
effective and compassionate communication with these patients and
their families is crucial.
5. ER nurses also need to communicate with nurses in other departments
of the hospital, especially intensive care unit nurses, who often see the
same patients. As a team, these nurses care for patients throughout
their stay and explain precautions to take to avoid returning to the
emergency room.
Stamina
 As an ER nurse, you’ll probably work three 12-hour shifts per week with
the potential for overtime pay. And depending on where you work,
you’ll could around 200 patients during any given shift. Also, you’ll be on
your feet the whole time.
 But if deskwork isn’t your thing—and adrenaline is—emergency room
nursing is definitely for you. Luckily, there are thousands of nursing jobs
on Monster at a variety of venues. Apply to one today, you won’t just
make a living, you’ll save lives.
Write some advice you would give for working in these stressful conditions.
 Track your stressors. Keep a journal for a week or two to identify which
situations create the most stress and how you respond to them.
 Develop healthy responses. Instead of attempting to fight stress with

fast food or alcohol, do your best to make healthy choices when you feel
the tension rise. Exercise is a great stress-buster.
 Establish boundaries. In today’s digital world, it’s easy to feel pressure
to be available 24 hours a day. Establish some work-life boundaries for
yourself.
 Take time to recharge. To avoid the negative effects of chronic stress

and burnout, we need time to replenish and return to our pre-stress
level of functioning.
 Learn how to relax. Techniques such as meditation, deep breathing

exercises, and mindfulness (a state in which you actively observe present
experiences and thoughts without judging them) can help melt away
stress.
 Talk to your supervisor. Employee health has been linked to productivity

at work, so your boss has an incentive to create a work environment
that promotes employee well-being.
 Get some support. Accepting help from trusted friends and family
members can improve your ability to manage stress.

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Name: Joselande Lormestoire

There is usually more than one of these:

 Coughing; wheezing; and  Shortness of breath

 Fainting, dizziness, confusion,  Swollen or itchy lips

 Hives; a rash; and itchy,  Swollen or itchy throat,

 Weak pulse, paleness

As many as 1 out of every 5 people may have a second anaphylactic reaction

The primary treatment of anaphylaxis is epinephrine injection into a muscle,

Typical food triggers for children are:

Common food triggers for adults are:

 Tree nuts (walnuts, hazel

Susceptible fish include albacore, amberjack, anchovy, Australian salmon,

Scombroid Poisoning Symptoms

Symptoms of scombroid poisoning generally begin 1 hour after ingestion of the

 Nausea  Abdominal cramps

Other symptoms may include:

 Hives  Unusual heart pounding

 Dropping blood  Racing heart  Wheezing.

Scombroid Poisoning Treatment

Scombroid poisoning should be treated with diphenhydramine (Benadryl) or

The answers of the questions on page 21.

First aid for Osgood-Schlatter

1. Everything in an emergency room moves fast, so it’s crucial that nurses

 Develop healthy responses. Instead of attempting to fight stress with

 Take time to recharge. To avoid the negative effects of chronic stress

 Learn how to relax. Techniques such as meditation, deep breathing

 Talk to your supervisor. Employee health has been linked to productivity

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