Introduction
Anaphylactic shock is a lethal allergic reaction that occurs rapidly while presenting varied signs and symptoms. Common signs and symptoms that anaphylactic shock presents are low blood pressure, swelling of throat, and itchy hives. Exogenous allergens such as food, venom from insects’ bites and stings, and medications cause anaphylactic shock. The allergens trigger immunologic and non-immunologic reactions resulting in lethal systemic effects. Depending on the presenting signs and symptoms, anaphylactic shock could require outpatient care or emergency care. The case of 7-year-old girl illustrates a form of anaphylactic shock, which required emergency treatment because it occurred rapidly and caused death within a short period (Moisse, 2012). Hence, nurses should be in a position to decipher whether patients require outpatient care or emergency care by examining presented signs and symptoms. Therefore, this essay aims to delineate multisystem physiologic progression of anaphylactic shock with a view of identifying if patients require outpatient care or emergency care.
Multisystem Physiologic Progression
Multisystem physiologic progression of the anaphylactic shock occurs through non- immunologic and immunologic mechanisms. Non-immunologic mechanism happens when exogenous substances such as opioids cause anaphylactic shock by binding on basophils and mast cells. In the immunologic mechanism, anaphylactic shock triggers a rapid immune response through the release of cytokines, antibodies, and inflammatory mediators. According to Brashers (2012), allergens trigger humoral immune response, which lead to massive production of immunoglobin E. Allergens trigger further immune responses by binding on mast cells and degranulate them. Consequently, mast cells release cytokines, which provoke extensive inflammatory responses and cause vasodilation and tissue edema owing to increased permeability of tissues. Brashers (2012) states that, “extravascular effects include constriction of extravascular smooth muscle, often causing laryngospasm, bronchospasm, and cramping abdominal pain with diarrhea” (p. 631). Thus, anaphylactic shock occurs due to a cascade of immune responses that allergens trigger and cause lethal systemic effects.
Emergency Care versus Outpatient Care
Severity of signs and symptoms that patients presents determines whether they need outpatient care or emergency care. When a patient presents signs and symptoms such as low blood pressure, itchy rashes, severe itching of the eyes, breathing difficulties, swallowing difficulties, vomiting, cramps, diarrhea, dizziness, wheezing sound, and angioedema, it means that the anaphylactic shock is severe and requires emergency attention (McPhee & Hammer, 2012). However, when a patient presents mild signs and symptoms like hives, itchy rashes, and tingling of the mouth, outpatient care can handle it by treating with epinephrine.
Age and Ethnicity
Age and ethnicity are two factors that influence progress of anaphylactic shock among individuals. Individuals below 30 years are prone to the anaphylactic shock caused by allergens present in diverse form of foodstuffs (Jacobsen & Gratton, 2011). This means that children are more susceptible to allergens than adults are. Additionally, ethnicity is the factor that determines the progression of anaphylactic shock among individuals owing to genetic predisposition. Individuals with genetic predisposition experience severe immune responses than those without genetic predisposition to anaphylactic shock.
Response to Colleague
Although gender and behavior are other factors that can influence the progression of anaphylactic shock, they do not have marked influence on pathophysiology of anaphylactic shock. Analysis of the impact of gender on progression of anaphylactic shock has shown that there are no significant differences among various forms of allergens. According to Chen, Mempel, Schober, Behrendt, and Ring (2008), allergens in food seem to affect women more than men. Regarding the factor of behavior, different behaviors influence the susceptibility to anaphylactic shock, especially the exposure to allergens. Frequent exposure to allergens enhances the severity of anaphylactic shock because of primed immune responses (Jacobsen & Gratton, 2011). Hence, gender and behavior are insignificant factors that determine the progression of anaphylactic shock.
Conclusion
Anaphylactic shock is an allergic reaction, which presents diverse signs and symptoms and immediately causes death. Immunologic and non-immunologic reactions are responsible for the occurrence of anaphylactic shock. As signs and symptoms of anaphylactic shock differ, severe signs and symptoms need emergency care, while mild ones require outpatient care. Age, ethnicity, gender, and behavior are four factors that influence the occurrence and prognosis of anaphylactic shock.
References
Brashers, V. (2012). Alterations of Cardiovascular Function. In S. E. Huether & K. L. McCance (Eds.), Understanding pathophysiology (pp. 585-637). St. Louis, MO: Mosby. Web.
Chen, W., Mempel, M., Schober, W., Behrendt, H., & Ring, J. (2008). Gender difference, sex hormones, and immediate type hypersensitivity reactions.Allergy, 63(11), 1418-1427. Web.
Jacobsen, R. C., & Gratton, M. C. (2011). A case of unrecognized prehospital anaphylactic shock. Prehospital Emergency Care, 15(1), 61-66. Web.
McPhee, S. J., & Hammer, G. D. (2012). Pathophysiology of disease: An introduction to clinical medicine. New York, NY: McGraw-Hill Medical. Web.
Moisse, K. (2012). Death of allergic student raises questions about school’s responsibility. Web.