""Thousands have suffered anaphlactic shock without organ damage, I've treated at least a few hundred in my career? Additionally, I'm sure he was treatd with epi then a course of either iv or PO sterioeds and not just "monitored." The reason I suggested that this is an exaggerated response in a specific individual, is because thousands have handled the toxin inappropriatly without such dramatic responses.
The person that this occured to is not reading this thread. The link above leads to theirs, so I doubt they'll be responding.""
Ed,
True i am post call and forgot that the individual was not on this forum
However...I disagree with your assessment...maybe another consequence of my sleep deprived state :hmm2:
The definition is literally inadequate perfusion resulting in the presence of multisystem endorgan hypoperfusion and damage (such as AMS, ARF, etc...). However, this damage is almost always reversible.
Anaphylaxis is the response to a sensitized individual to a specific antigen. These individuals (for unknown reasons) have "faulty" immune response to particular insults (bee venom, peanut oil, etc) and release various cytokines and histamines. The result is massive hypotension, edema (laryngeal) and bronchospasm. Usually mediated by aberrant IgE immunoglobins.
The individual in question however had the opposite (except for the tightness in his chest which can be explained by something else, namely coronary vasoconstriction). He had an increase in Blood pressure and numbness/tingling suggesting vasoconstriction and neuro involvement (namely fast sodium potassium channels). None of that is present in anaphylaxis.
i doubt they gave the guy epi which is a potent alpha and beta agonist. Alpha --> vasoconstriction in both the central and periphery; Beta --> increase heart rate from Beta 1 receptors; his BP and HR were already too high (180/90 and 154 i think i remember). Epi would have been disastrous in that case most likely causeing a hypertensive crisis and possible CVA. But i agree they would have given him IV steroids and benedryl to try to mediate the reaction to the toxin.
On a personal note: that is a "yes" to being a hospital slave and am currently applying to get the hell out of that position as we speak
:beer:
