ABC: časopis urgentne medicine (Jan 2014)

Anaphylaxis, successful cardiopulmonary resuscitation out of hospital

  • Niković Vuk,
  • Bulajić Ranka,
  • Nenek Srđan

Journal volume & issue
Vol. 14, no. 1
pp. 59 – 64

Abstract

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INTRODUCTION: Anaphylaxis is a serious allergic reaction that is rapid in onset and may cause death. Coronary artery spasm may occur with subsequent myocardial infarction, dysrhythmia, or cardiac arrest. Those with underlying coronary disease are at greater risk of cardiac effects from anaphylaxis. The coronary spasm is related to the presence of histamine-releasing cells in the heart. Cardiopulmonary resuscitation (CPR) is an emergency procedure for manually preserving brain function until further measures to restore spontaneous blood circulation and breathing in a person who is in cardiac arrest. It is indicated in those who are unresponsive with no breathing or abnormal breathing, for example, agonal respirations. CASE REPORT: This is a case report of a 56 years old female with anaphylactic shock after a successful cardiopulmonary resuscitation (CPR) . After the call our team was send to the patient's household. The patient was on the floor, unconscious. She was cyanotic, with very weak respiratory effort and decrease respiratory rate. As per patient's husband present at the scene , the patient has history of COPD. She took Ibuprofen(tablet400 mg). Her conditon was deteriorating . She was not breathing, and the pulse was not palplable. Cardiac monitor was showing asystoly. CPR was started iv line was placed. After 2 series of compression the patient was intubated. CPR was continued and after 15 minutes the pulse was palpable and the patient was transferred to hospital- Clinical Ceneter for futher investigation and treatment. During the transport her GCS was improving but patient was still unconsciousness. During hospitalization underwent a complete diagnostic and she was treated with H2 blockers, low molecular weight heparin, bronchodilatators and, xanthine therapy. She was discharged after 7 days of hospitalization. CONCLUSION: The sooner CPR is started the better is the outcome. In the first 3 minutes the chance of return of spontaneous circulation is 75%. After 4 minutes is 40%. After 5 minutes the chance of return of spontaneous circulation is minimal.

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