9. Incidence
• 4–100 per 100,000 persons per year
• The risk is greatest in young people and
females
• Death from anaphylaxis is most commonly
triggered by medications.
10. Substances Known To Trigger
Anaphylaxis In Sensitized Persons
Hormones
• Insulin
• Vasopressin
• Parathormone
Enzymes
• Trypsin
• Chymotrypsin
• Penicillinase
16. Pathophysiology
Subsequent sensory response
More of same allergen invades body
Allergen combines with IgE attached to mast cells, which
triggers release of histamine from mast cell granules
Histamine causes blood vessels to dilate and become
leaky which promotes edema; stimulate release of large
amounts of mucus and causes smooth muscles to
contract
21. Diagnostic evaluation
• Health history
• Physical examination
• Allergy testing
• White blood cell count
• Radioallergosorbent test (RAST)
22. Management
Immediate treatment for anaphylaxis
Parenteral epinephrine
An adrenergic agonist (sympathomimetic) drug
that has both vasoconstricting and
bronchodialating effects
mild reactions subcutaneous injection of 0.3ml
to 0.5ml of 1:1000 epinephrine
23. Management
With injected toxins such as a bee sting, an
additional amount equivalent to one half the
above may be injected directly into the site of
sting and a tourniquet is applied above it to
prevent further systemic absorption.
Intravenous epinephrine is using a 1:100000
concentrations may be used in the client with a
more severe anaphylactic reaction.
25. Other treatment
• Airway management takes the highest
priority for clients with an acute anaphylactic
reaction. Insertion of an endotracheal tube or
emergency tracheostomy may be required to
maintain airway patency with severe laryngospasm
• Plasmapheresis: Removal of harmful
components in the plasma may be used to treat
immune complex responses such as
glomerulonephritis.
26. Nursing Management
Ineffective airway clearance related to bronchospasm or
laryngeal edema
• Administer oxygen
• Assess respiratory rate and pattern, level of
consciousness and anxiety, use of accessory muscles for
respiration, chest wall movement, audible stridor;
auscultate lung soundsand any adventitious sounds.
• Insert a nasopharyngeal tube or oropharyngeal
airway and arrange for immediate intubation if indicated
• Administer subcutaneous epinephrine as
prescribed.
• Provide calm reassurance
27. Nursing Management
Decreased cardiac output related to peripheral
vasodialation and increased capillary permeability from
the release of histamine
• Monitor vital signs frequently
• Assess skin colour, temperature, capillary refill,
edema and other indicators of peripheral perfusion
• Monitor level of consciousness
• Administer warmed intravenous solutions of ringer
lactate or normal saline as prescribed
• Insert an indwelling catheter and monitor urinary
output frequently
• Once breathing is established place the client with
legs elevated
29. Introduction
Septicemia is bacteria in the blood that often
occurs with severe infection.
Septicemia is a serious and even life threatening
infection of the blood Usually it is caused by
bacterial infection, but fungi and other
organisms also cause this wide spread infection
of the blood stream
30. DEFINITION
Invasion of the bloodstream by virulent
microorganisms and especially bacteria along
with their toxins from a local seat of infection
accompanied especially by chills, fever, and
prostration
31. INCIDENCE
• 18 million cases per year
• Sepsis occurs in 1–2% of all hospitalizations
• Due to it rarely being reported as a primary
diagnosis (often being a complication of
cancer or other illness), the incidence,
mortality, and morbidity rates of sepsis are
likely underestimated
33. RISK FACTORS
• The very young and the elderly
• infections
• People in an intensive care unit
• People with weakened immune systems
• People with pre-existing medical conditions
• People with devices such as IV catheters,
breathing tubes, or other devices
• People with extensive burns
• People with severe trauma
34. ETIOLOGY
Bacteria usually spill over from the primary
infection site into the blood and are carried
throughout the body thereby spreading
infection to various systems of the body.
• Osteomyelitis
• Meningitis
• Endocarditis
• UTI
• Peritonitis
39. MANAGEMENT
• Broad spectrum Antibiotics
• IV fluids
• Oxygen inhalation
• Plasma and other blood products
• Vasopressors
• Steroids
40. NURSING MANAGEMENT
Goal of nursing management are
• Infection control
• Support tissue perfusion
• Prevent complications
• Provide information about disease process,
treatment needs
41. NURSING MANAGEMENT
• Provide isolation to patient
• Control visitors
• Wash hands with antimicrobial hand wash
before and after each activity
• Provide frequent position change
• Deep breathing exercises/ coughing
exercises
• Follow standard precautions while caring
patient
42. NURSING MANAGEMENT
• Wear mask and gown and gloves when providing direct
care to prevent cross infection
• Dress wound with aseptic technique if present
• Limit use of invasive devices/ procedures if possible
• Maintain TPR and BP
• Maintain intake output chart
• Obtain blood, sputum, urine, and wound culture
initially
• Initiate broad spectrum antibiotics as prescription
• Assess patient’s hemodynamic parameters every
hour
44. EVIDENCE BASED PRACTICE
Umbilical cord-derived mesenchymal stem
(stromal) cells for treatment of severe sepsis: a
phase 1 clinical trial.
A single intravenous infusion of allogeneic MSCs
up to a dose of 3 × 106 cells/kg was safe and well
tolerated in 15 patients with severe sepsis.
46. EVIDENCE BASED PRACTICE
BACKGROUND:
Food urticaria is common and generally benign, and it may be of viral or
idiopathic aetiology. A food origin of the allergy is frequently sought but
rarely found. Mammalian meat anaphylaxis, or alpha-galactose (α-gal)
anaphylaxis, is a rare and recently discovered entity.
PATIENTS AND METHODS:
Herein, we report a case of alpha-galactose (α-gal) anaphylaxis in a 60-
year-old woman presenting four episodes of acute urticaria with signs
of anaphylaxis occurring a few hours after meals containing mammalian
meat (beef meat, pork meat and offal). The diagnosis was confirmed by
a positive gelatine prick-test and the presence of α-gal IgE.
47. EVIDENCE BASED PRACTICE
DISCUSSION:
In the event of acute urticaria associated with
systemic symptoms, in particular gastrointestinal
signs, allergy to α-galactose should be considered.
