 Welcome to Nursing School Explained in this video on anaphylactic shock. So what happens physiologically, it is an acute life-threatening allergic reaction. Most commonly the triggers can be insects and bee stings are very common here. Benins such as from a poisonous animal and that can be anything like from a scorpion to a snake. Drugs and antibiotics can be the cause here or you might be familiar with asinhibitors being able to cause angioedema and then maybe even anaphylaxis. And then people can be allergic or anaphylactic to food as well. And common things that come to mind here are peanuts for example. So what happens the body responds to the exposure to this trigger by a massive vasodilation which then causes a very significant and sudden drop in blood pressure and it can lead to circulatory failure. All of a sudden the blood vessels are completely leaky and the patient loses all of their intravascular volume. And then release of vasodilactic mediators occurs that are in response to this trigger which increases the capillary permeability and that also affects the lungs. And then we have all this fluid and constriction of the bronchioles leading to laryngeal edema and bronchospasm which can be life-threatening if not treated in a timely manner. So signs and symptoms will be very sudden after the exposure to the trigger. The patient will be complaining of chest pain because of this reaction that happens in the lungs. There will be wheezing because of the constriction of the airways that might be swelling of the lips and the tongue. And so we have to really be concerned about the airway that might be strider as the airway is closing off. The patient might also have flushing, have a pretty significant rash and uricaria meaning itching all over. There might be angioedema which means swelling to the lips and the mucosal surfaces of the mouth. So again we have to worry about the airway. The patient might be very anxious and have a sense of impending doom. And whenever you hear that impending doom and the patient tells you, I feel like I'm going to die. We need to take that very, very seriously because they kind of have that innate feeling that something has gone really, really bad. And then they might also be incontinence. So treatment for anaphylaxis is, number one, prevent exposure to these triggers that might be causing that. So whether that means not getting exposed to bees or not taking certain medications is very important. However, the patient usually only knows after they've been exposed once or twice. So they might not know that they might have an anaphylactic reaction to one of those triggers. But when an anaphylactic reaction occurs, we have to remove the trigger. So if this is an infusion of an antibiotic, we need to turn that pump off. If there is still a stinger from a bee in the skin, we need to take that stinger out. And then we need to manage their ABCs. So airway, if there is significant impairment of the airway because of the laryngeal edema in bronchospasm, evidenced by stridor, wheezing, chest pain, all this airway edema, the patient might need to be intubated just to protect their airway. In terms of their breathing, we might give them bronchodilators to help with the bronchospasm and the bronchoconstriction. And that is typically albuterol. But we can also administer aerosolized epinephrine and then certainly support them with some oxygen. And then for circulation, we need to give them IV fluids. And those will be large amounts of isotonic fluids that will remain in the intravascular space because we have this massive base of dilation that causes the blood pressure to drop. And then other medications that are given many times are intramuscular epinephrine. And this is also something that the patient will have a prescription for. If they, let's say, are anaphylactic to bees, then they will carry this epipen with them because they might not know when they next get exposed to a bee. And epinephrine helps with peripheral vasoconstriction. So now we're counteracting this vasodilation that this substance is causing by a base of constricting, hopefully, bringing up their blood pressure. It also bronchodiolates, which helps with the airway edema and bronchospasm. And it blocks histamine, which is really at the background of the pathophysiology that's occurring here. And then we give the patient benadryl, which is in histamine 1 blocker and H1 blocker. We give them H2 blockers that are sometimes or many times only used for GI stuff, stomach issues. Runitidine is an example where Zantac, so H2 blockers, they block histamine 2. And then the patient might also receive corticosteroids if the low blood pressure persists after we've done these other things here, supporting them with ID fluids, including the epinephrine and the benadryls. Many times the patient, even if they're being discharged, they might be going home with a short course of a tapered corticosteroid to counteract all these underlying pathophysiological mechanisms that have triggered the anaphylaxis into the gateway. Thank you for watching this video. Please also consider watching my other videos on the other shocks, such as hypovolemic shock as well as neurogenic shock and spinal shock. And thanks for watching Nursing School Explains. See you soon.