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Category: Medical

Topic: Immunology

Level: EMT

Next Unit: Anatomical Defenses Against Contaminants

4 minute read

ANAPHYLAXIS is a rapidly progressing, life-threatening systemic allergic reaction.

In anaphylaxis, the reaction to the allergen has gone out of control, signs of anaphylaxis progress from wheezing and severe respiratory distress (or just wheezing) to a silent chest in the respiratory system accompanied by signs of hypoperfusion (rapid pulse and low blood pressure/hypotension), pale, red, or cyanotic skin, hives, itching, swelling around eyes, mouth or tongue, altered mental status, nausea, and vomiting. They involve mast cells and IgE.

ALLERGIC REACTIONS, in contrast, are localized to one or several areas of the body and are rarely life- threatening, even though they also are mediated by IgE.

A mild allergic reaction often results in cutaneous swelling and possibly other nonlife-threatening symptoms like itching. Moderate allergic reactions include upper and lower airway symptoms, cardiovascular, gastrointestinal, and neurological symptoms as well as cutaneous symptoms.

During an allergic reaction, a respiratory assessment may reveal sneezing, tightness in chest, cough, rapid and labored breathing, wheezing, or stridor. The patient may also have an increased heart rate, pale or red skin, hives, localized or generalized swelling, itching, anxiety, itchy and watery eyes, and dizziness.

We should seek to rule out anaphylaxis first since it's the more serious of the two.

In the field, differentiating between allergic reaction and anaphylaxis is an urgent obligation, but herein presents the most important consideration with simple allergic reactions:

An allergic reaction can develop into anaphylaxis, so even if an assessment does not reveal signs of anaphylaxis, you should retain an index of suspicion that anaphylaxis may occur.

One tell-tale sign of anaphylaxis may be compensated shock (distributive shock) with vasoconstriction causing diaphoretic skin. 

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