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TREATING ANAPHYLAXISIn the emergency setting anaphylaxis is a dangerous life threatening conditionthat must be treated in an aggressive and timely fashion Anaphylaxis isa condition related to acute allergic reactions Following the bodysexposure to the offending allergen there are common systemic reactionsThe most serious reactions involve the respiratory and cardiovascular systemsbut the gastrointestinal dermatologic and genitourinary systems are ofteninvolved causing varied symptoms such as urticaria flushing angioedemabronchospasm hypotension cardiac arrythmias nausea intestinal crampspruritus and finally uterine cramps Physician Assistant 894 The abovelist is by no means exhaustive specific symptoms vary from person to personThe same person suffering from several anaphylactic reactions can also presentwith differing symptoms Physiologically speaking the two main effects of the bodys releasedmediators IgE during an anaphylactic reaction are smooth muscle contractionand vasodilatation which cause most of the bodys adverse symptomsJAMA 112682 Since the most life threatening reactions usually involvethe respiratory and cardiovascular systems that is where emergency treatmentis focused In the cardiovascular system a combination of vasodilatationincreased vascular permeability tachcycardia and arrhythmias can lead tosevere hypotension In the respiratory system the swelling of tissues alongwith bronchospasm and increased mucus production are the main cause of deathSo if untreated anaphylaxis can be fatal as a result of the bodysgoing into what is essentially shock while simultaneously and more importantlybeing deprived of the oxygen needed to sustain life As of today there is one universally accepted treatment for acute anaphylaxisEpinephrine Epinephrine is both an alpha and a beta agonist This makesit the drug optimally suited to treat anaphylaxis Epinephrine will increasevascular resistance reduce vascular permeability produce bronchodilationand increase cardiac output Emergency 1093 Epinephrine will directly counteract the potentially life threatening aspectsof anaphylaxis Epinephrine can and is used in the both the pre-hospitalenvironment as well as in definitive care institutions Epinephrine is widelyadministered by ALS providers the world over The drug is so effective thatand relatively simple to use that subcutaneous administration ofepinephrine by EMT-Bs trained in recognition of anaphylaxisis safe Annals of
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