According to media reports:
On January 24, a 3-year-old child in Danyang City, Jiangsu Province suffered from discomfort during infusion in the local health center and died after ineffective rescue. The preliminary judgment was that the cause of death was anaphylactic shock.
According to the local Health Planning Commission, The child went to the pediatric clinic of Jiepai Township Health Center at 4: 08 pm on the 24th. Clinical diagnosis [bronchitis]. After negative cefazoxime skin test, the child was treated with cefazoxime intravenous infusion at 4: 50. Half an hour after infusion, the child appeared pale complexion and cyanotic lips. The nurse immediately reported to the doctor on duty to organize rescue. At 6: 25 p.m., the child died after ineffective rescue.
Such a sudden death is hard for the family to accept. Why did the infusion go into shock? The anaphylactic shock that caused the death of the child was what again?
The following clove mother will tell you about this matter, hoping that you can pay attention to it and avoid such tragedies again.
Negative skin test, allergy?
Many people know that skin tests must be done before penicillin is injected, just because they are worried about allergy. < < Pharmacopoeia of the People’s Republic of China > > also stipulates that skin tests must be done before injecting or (partially) taking penicillin antibiotics orally. If the skin tests are positive, skin tests should be done again when changing batch numbers.
However, skin tests can only diagnose 5% of allergic patients [2], so negative skin tests cannot be said to be non-allergic. Even if antibiotic skin tests are negative, allergic reactions or even anaphylactic shock may occur.
What is anaphylactic shock?
Anaphylactic shock is a serious allergic reaction, which only occurs in people who are allergic to certain things. It occurs relatively quickly [1]. It usually occurs within a short period of time after taking drugs. For example, about half of penicillin allergy patients have allergy within 5 minutes after taking drugs. Symptoms include:
(1) Abnormal redness of the skin, often accompanied by sweating, erythema on the body, large raised rashes, etc. in a short period of time, edema on the mouth and eyelids of some people, pruritus on the skin of hands and feet, etc.;
(2) The voice suddenly becomes hoarse and cannot make a sound. It is very likely that allergy causes edema in the throat, which will lead to asphyxia and death.
(3) Sudden cough, wheezing, shortness of breath or dyspnea, etc.;
(4) Nausea, vomiting, abdominal pain, diarrhea, etc. Abdominal pain is especially common when allergic reactions occur.
(5) dysphoria, crying uneasiness, convulsions, lethargy and even coma, etc.
Some allergic people may suffer from shock as soon as the allergic reaction occurs, with pale complexion, cold hands and feet, cold sweat, blue skin, especially blue lips and nails, indifference of mind, etc.
Most allergic reactions occur in the process of medication, so when medication is used, especially during intravenous infusion, we must pay attention to the observation of patients. If we find these manifestations mentioned above, we must immediately call the medical staff and rescue them in time.
Which drugs may cause anaphylactic shock?
There are many drugs that can cause anaphylactic shock, the most common of which are-lactam antibiotics and non-steroidal anti-inflammatory drugs.
Antibiotics
- Penicillin and various penicillin antibiotics named after [* * cillin] such as [amoxicillin]; Various cephalosporin antibiotics named after [cephalosporins * *] such as [ceftriaxone]; Various carbapenem antibiotics named after [* * penem] such as [imipenem].
Compared with oral medicine, injection type is more likely to cause anaphylactic shock:
For example, sultamicillin, amoxicillin, piperacillin, penicillin sodium, etc. in penicillin antibiotics; Cefotaxime, cefoperazone, ceftriaxone and other cephalosporin antibiotics.
Non-steroidal anti-inflammatory drugs
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Including commonly used painkillers, antipyretics, etc., represented by aspirin, etc., as well as acetaminophen, ibuprofen and other antipyretics commonly used in children.
Traditional Chinese Medicine Injection
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Don’t think traditional Chinese medicine is nontoxic. Anaphylactic shock caused by Chinese patent medicine injection such as Houttuynia cordata injection, Shenmai injection, Qingkailing injection, Yanhuning injection and zedoary turmeric oil injection is also common.
Is it certain that people will die if allergy occurs?
Allergy does not necessarily lead to anaphylactic shock, and anaphylactic shock does not necessarily cause death.
Generally speaking, the earlier the symptoms appear, the faster the disease progresses, which often indicates that the more serious the disease is, the higher the risk of death.
The success or failure of the rescue depends on whether it can be found in time and whether timely and effective treatment measures can be given. The more timely the treatment, the better. Therefore, if any allergic reaction mentioned above occurs during the medication process, even if it is only a less serious allergy such as skin redness, it is necessary to seek help from medical staff in time and take timely measures to prevent the disease from worsening.
However, even if the rescue is carried out in time, there may also be situations like the one in the news, where all efforts have not been made to rescue them.
As the results of skin tests cannot be fully believed, the incidence of anaphylactic shock also has an increasing trend in Europe, America and other countries, but skin tests are not mentioned, because they believe that negative results are easy to cause negligence of doctors, and false positives (skin tests for non-allergic people may also be positive) interfere with drug selection [3].
Aren’t they afraid of allergies? Or is it because their drugs are safer?
No, they rely on the training of doctors and the health education of patients, and provide people who are likely to suffer from anaphylactic shock with a portable device [4]. In case of an accident, patients can inject themselves with epinephrine drugs for rescue at the first time [5].
However, there is currently no such device mentioned above in our country. Apart from skin tests, there are also what methods to prevent allergy?
How to prevent serious allergic reactions?
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When seeing a doctor, he took the initiative to tell the doctor about the allergy history: for example, the history of severe allergy, food allergy, drug allergy, severe asthma, bee venom allergy, and the drugs currently being taken.
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Take drugs as orally as possible: Because injections are more prone to anaphylactic shock, for mild and moderate infection (including bronchitis and pneumonia), try to choose oral antibiotics for treatment [6]. If the disease requires infusion or muscle injection, the doctor should inform the patient what kind of anaphylactic reaction may occur so as to facilitate the patient’s observation. Try to avoid fasting skin test and injection medication.
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Note observation: Although most allergic reactions occur in the process of medication, some people will have allergy after medication. Therefore, don’t leave the hospital in a hurry after injection and infusion. You should stay for observation for at least 30 minutes. If suspicious allergic reactions occur, you should seek help from medical staff in time.
I hope this accident can give parents and doctors a warning and carefully use allergic drugs, especially injections. Don’t take it lightly because the skin test is negative, but also pay attention to observation. Once there is an accident, rescue it in time.