Out-of-Hospital treatment of anaphylactoid reactions

Abstract

The term anaphylactoid reaction is a generic term used for allergic reactions with symptoms of anaphylaxis. Anaphylaxis is a severe systemic allergic reaction that is potentially fatal. It requires prompt recognition and immediate management. The syndrome can affect virtually any organ in the body, although reactions involving the respiratory, the cardiovascular, the cutaneous and the gastrointestinal systems are most common. Anaphylaxis is caused by the release of mediators from mast cells and basophiles. Reactions typically follow a uniphasic course; however, 20% will be biphasic in nature. The second phase usually occurs after an asymptomatic period of 10 hours in the mean. Adrenaline is the pharmacological treatment of choice and should be used in all patients showing signs of beginning blood pressure decrease or upper airway oedema. Further therapy in the treatment of anaphylaxis includes circulatory support, volume therapy, antihistamines and corticosteroids. Post-treatment observation of these patients is absolutely necessary. Once recovered, patients should be hospitalized and monitored for the following 24-48 hours.