 Hello everyone, welcome back to another session in dentistry and more. So today's topic in oral surgeries management of anaphylactic shock So anaphylaxis Is nothing but a manifestation of immediate hypersensitivity. So it is a type 1 hypersensitivity That is a allergic reaction So in which exposure of a sensitized individual to a specific antigen Results in a life-threatening respiratory distress. Okay, so it will result in life-threatening respiratory distress So this hypersensitivity we learned in our second year of dentistry In microbiology where we learn type 1 type 2 type 3 type 4 Hypersensitivity reaction. So this is the most dangerous one So it is usually followed by a vascular collapse and shock Accompanied by pruritis, articaria and angioedema. So there will be pruritis Articaria and Angioedema Whereas the pruritis is nothing but an uncomfortable irritating sensation that creates an urge to scratch that can involve any part of the body Whereas articaria means a skin rash triggered by a reaction to food medicine or other irritants and angioedema Is a painless swelling under the skin triggered by allergy to pollen, drugs, venom, food or medication. So these are the most common symptoms of hypersensitivity So what are the causes of anaphylaxis? So the most common causes are medications including antibiotics, especially Penicillin and sulphur drugs. So causes One can be medication Mainly Penicillin and sulphur drugs, then it can be vaccines, opiates, aspirin NSAIDs, local anesthetics, IV fluids Insulin. So anything can be a cause for anaphylactic shock So any medication should be test dose done before the application to avoid this serious Anaphylactic shock, which is a respiratory disease, which is a life-threatening one So that is medication and also the can be Food such as milk, egg The wheat, seafood. Seafood is a very common allergen which creates anaphylactic shock So it varies from person to person. So one person all of these Will not create any problem, but maybe the second person one of the product might cause allergic reaction. So we cannot Say that which causes which person so it varies from person to person So it depends upon the person's immunity and person's reaction to the allergen And also this is related to food. Also we have the stings by fire ants and The bees, wasps and yellow jackets. So all stings can also result in anaphylactic shock and the blood products blood products Including plasma, immunoglobulin Cryo precipitate and whole blood can also result in anaphylactic shock Idiopathic causes are also there So physiology of anaphylactic shock is it occurs only in those people who have Previously been exposed to allergen the person is already exposed. So the second time is The anaphylactic shock is happening. So the patient who is exposed to allergen there will be an incubation period So this is a patient So this is the first time first time the patient exposed to the allergen nothing happened Okay, then there will be an incubation period. So the first time there is no symptoms And after this there will be production of antibodies. So antibodies will be produced because there is an allergen here So any allergen there will be antibodies production in the body So when the patient is exposed to the same allergen for the second time Okay, so the second time it will result in anaphylactic shock So sometimes it is called as shock dose Shock because the same allergen on a second time is creating anaphylactic shock So the most common science and symptoms we already discussed that is prurates, otteria and angioedema So the science and symptoms are most commonly seen in the skin gastroentestinal Respiratory or circulatory system. Okay, so these science and symptoms are not too dangerous But they do have the potential to become life-threatening if they are located in some specific areas So just if angioedema around the mouth or throat could cause death because of the airway Obstruction, so mostly it is becoming life-threatening when this angioedema is causing airway obstruction if it is creating edema on the air passage there will be airway obstruction and the patient Is having chance to die So gastroentestinal symptoms include nausea, vomiting, diarrhea, the respiratory or sneezing curve Weakness, tightness in chest, bronchus, pasum varying degrees of airway obstruction because airway obstruction is very common, patient is Having agonal breathing, patient is trying very hard to breathe Most often due to this laryngeal edema a swelling of the larynx that occurs as a result of Allergic reaction and the swelling may be great enough to cause partial or complete obstruction of the airway So the most common cause of death in anaphoretic reaction is the airway obstruction So the circulatory symptoms include hypertension, shock, cardiac arrhythmia and Circulatory collapse also there will be syncope, tachycardia and palpitations So diagnosis is very important. We need to diagnosis as early as possible So diagnosis would be relatively very easy Seeing the signs and symptoms which occurs immediately after expression. Sometimes the patient eats seafood and starts Expressing these signs and symptoms. So one has to notify it as early as possible and get the treatment done So in that situation almost immediately the patient would feel faint and weak Would begin sweating and will become anxious and restless So then patient develops severe itching sensation as a result of this allergy Then it proceeds through the gastrointestinal respiratory and circulatory stages So if the cycle is not stopped the end result would be death. So how do we treat this? So the first thing is seeing the signs and symptoms. We should make sure that it is anaphylactic shock Then someone medical assistants place the patient in supine position Patient should be in supine position Then we should administer oxygen Okay, and we need to administer Epinephrine. This is the life saving drug of anaphylactic patients epinephrine That is dosage 0.3 to 0.5 milligram Initial dose can be intramuscular injection or 0.1 mg IV intravenously can be given. So these doses should be repeated as necessary until the resolution of the event Then we can also give antihistamines as Needed then we can start initiate CPR risk cardio pulmonary resuscitation and in worst cases we can perform critical Thyatomy So that is the sequence supine position oxygen epinephrine and testamines CPR and critical thyatomy So that is how we deal a patient of anaphylactic shock So we discussed What is anaphylactic shock? What are the causes? And how do we treat this and what are the signs and symptoms? So hope you understood the small concept of anaphylactic shock. It is It is asked few times how to manage the anaphylactic shock So it is an allergic reaction. So I'll come up with a new topic in oral surgery. Thank you