Differentiating between anxiety, syncope anaphylaxis and prompt management of anaphylaxis
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Anaphylaxis is a severe, potentially life-threatening reaction caused by the release of chemical mediators from mast cells. It involves multiple organ systems and symptoms include hives, difficulty breathing, low blood pressure, nausea and vomiting. Onset is usually within 30 minutes but can be delayed up to an hour. Syncope is a brief loss of consciousness due to low blood pressure. Symptoms include dizziness, weakness, pale skin. Onset is sudden and recovery within 1-2 minutes. Anxiety involves feelings of tension, worry and physical symptoms like increased heart rate. Symptoms can include rapid breathing, nausea and pale, sweaty skin. Onset is before or during the event and recovery
Differentiating between anxiety, syncope anaphylaxis and prompt management of anaphylaxis
- 1. Differentiating between anxiety, syncope & anaphylaxis And prompt Management of Anaphylaxis
- 2. 2 Anaphylaxis Anaphylaxis is an acute, potentially fatal, multiorgan system reaction caused by the release of chemical mediators from mast cells and basophils. The classic form involves prior sensitization to an allergen with later re-exposure, producing respiratory, cardiovascular, cutaneous, or gastrointestinal manifestations resulting from exposure.
- 3. 3 Syncope Syncope is defined as a transient, self-limited loss of consciousness with an inability to maintain postural tone that is followed by spontaneous recovery. Presyncopal symptoms reported may include the following: – Prior faintness, dizziness, or light-headedness (70% of cases of true syncope) – Prior vertigo, weakness, diaphoresis, epigastric discomfort, nausea, blurred or faded vision, pallor, or paresthesias anxiety The American Psychological Association (APA) defines anxiety as “an emotion characterized by feelings of tension, worried thoughts and physical changes like increased blood pressure.” At our center we observed some symptoms such as: 1. nervousness, restlessness, or being tense 2. palpitations 3. Sweating 4. weakness and lethargy
- 4. 4 Anaphylaxis & Syncope & Anxiety Manifestation 1. Onset 2. General disposition 3. Skin/Mucosa 4. Breathing 5. Blood Pressure 6. Abdomen/GI 7. Pulse
- 5. 5 Onset ANAPHYLAXIS Usually slower 5-30 minutes after immunization Sometimes onset not for an hour Post recovery prolonged 20% are biphasic with a second phase 2-9 hours SYNCOPE Sudden Before during or immediately after immunization Recovery within 1-2 min ANXIETY Before, during or shortly after •Recovery is usually rapid
- 6. 6 General disposition ANAPHYLAXIS Sense of impending doom, agitation If loss of consciousness: Usually have warning signs Gradual fall to floor Tonic-clonic jerking unlikely SYNCOPE Light- headedness/dizziness Numbness/weakness Tingling around lips/extremities Slumping to floor Tonic/Clonic posturing possible if hypoxia severe enough ANXIETY •Fearfulness •Light headedness/dizziness •Numbness/weakness •Tingling around lips and extremities
- 7. 7 Skin/Mucosa ANAPHYLAXIS Flushed, red Generalized hives – Look at the injection site Progressive painless swelling about face, mouth, tongue, uvula. SYNCOPE Pale Excessive perspiration Cold and clammy ANXIETY Pale Excessive perspiration Cold and clammy
- 8. 8 Breathing ANAPHYLAXIS Sneezing, coughing, wheezing, difficulty breathing Upper airway swelling (indicated by hoarseness and/or difficulty swallowing) SYNCOPE Normal or Shallow, irregular, difficulty ANXIETY Rapid Shallow
- 9. 9 Blood Pressure ANAPHYLAXIS Decreased SYNCOPE Decreased ANXIETY Normal Elevated systolic Abdomen/GI ANAPHYLAXIS Persistent Nausea and vomiting Crampy, abdominal pain, diarrhea SYNCOPE Nausea ANXIETY Nausea Pulse ANAPHYLAXIS Rapid, weak SYNCOPE Slow ANXIETY Rapid
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- 12. 12 • American Family Physician - A Practical Guide to Anaphylaxis (https://www.aafp.org/afp/2003/1001/p1325.html) • UpToDate - Anaphylaxis: Emergency treatment (https://www.uptodate.com/contents/anaphylaxis-emergency-treatment) • Medscape - Drugs & Diseases -Emergency Medicine – Syncope (https://emedicine.medscape.com/article/811669-overview)