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Abbas, M., Moussa, M., & Akel, H. (2022, January). Type I Hypersensitivity Reaction. NIH National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK560561/#

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Itching
Erythema
Headaches
Vomiting
Abdominal cramps
Diarrhea
Breathing Difficulty

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Smooth muscle bronchial contraction
Laryngeal edema
Vascular collapse
Reduced blood pressure
Shock
Death

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Both:

Need exposure to antigen (usually environmental) at least once, (sensitization stage)

Mediated by IgE

Happens within 24 hours (effect stage)

Are an imbalanced reaction to stimuli systemic and local

Anaphylaxis Specific:

the most dramatic, happens within minutes

Idiopathic Anaphylaxis: "without known exposure to common allergens" (AAFA)

Exercise Induced Anaphylaxis: very rare, vigorous exercise is trigger, other environmental factors could be contributing to response

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Pain
Swelling
Redness

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Here is a quick video summarizing Anaphylaxis. In this video it reviews the pathophysiology, as well as the specific categorical "type" of hypersensitivity reaction that it is. Signs/Symptoms are discussed and Interventions are mentioned to provide a clear understanding for those who already have or may experience this in the future.

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Genetic predisposition: family anaphylaxis, allergies, asthma, or hypersensitivity reactions

Personal history of hypersensitivity reactions, allergies, asthma, or anaphylaxis

Previous exposure to antigen

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1. Allergen attaches to antibody that is linked to a B cell

2. That body responds by producing IgE antibodies against the allergen

3. IgE molecules bind to receptors located on the mast cells and basophils

4. Now that the basophil/mast cell is layered with these antibodies, an exposure to the same allergen will result in the allergen binding to adjacent IgE molecules, which conjoins the receptors

5. A cascade signal is sent out through the body which triggers the release of mediators like histamine that produce arachidonic acid metabolites like prostaglandins

6. Histamine plays a role in stimulating vasodilation and increasing heart rate

7. Prostaglandins play a role in bronchoconstriction, pulmonary and coronary vasoconstriction, and a peripheral vasodilator

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Immediate injection of epinephrine

Increases blood flow, widens airways, and may relieve some symptoms temporarily

Antihistamines

Relieve symptoms of allergies including fever, hives, conjunctivitis

Beta-agonists

Alleviate bronchoconstriction

Vasopressors

Helps correct hypotension

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American Academy of Allergy Asthma and Immunology. (n.d.). Feel Better. Live Better. See and Allergist/Immunologist. https://www.aaaai.org/Tools-for-the-Public/Conditions-Library/Allergies/Feel-Better-Live-Better-See-an-Allergist-Immunolog

American Academy of Allergy Asthma and Immunology. (n.d.). Anaphylaxis. https://www.aaaai.org/conditions-treatments/allergies/anaphylaxis

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Asthma and Allergy Foundation of America. (2017, February). ANAPHYLAXIS: A Severe Allergic Reaction. https://www.aafa.org/anaphylaxis-severe-allergic-reaction/

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Vascular Effects

Increased capillary permeability (cytokines, histamine)

Leukocyte emigration (Cytokines)

Vasodilation of smooth muscles (Leukotrienes)

bronchoconstriction

Respiratory & GI tracts:

Susceptible to eosinophil "invasion". Triggers bone marrow production and release of more eosinophils to the blood.

Increased mucus secretions

Narrowing of the airway (bronchoconstriction) & increased edema in the larynx

Systemic Effects

Relative Hypovolemia (low blood volume)

Decreased cardiac output (hypotension)

Decreased tissue profusion

Impaired cellular metabolism

Shock & Death

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Management of Severe Cases of Anaphylaxis

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Management of Severe Cases of Anaphylaxis

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Identify triggers
Determine if genetic factors present
Prevention of recurrence

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Cerbral, renal, or hepatic ischemia and possible organ failure if not treated

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Monitor patients after injections or vaccines for potential anaphylaxis symptoms

Consider allergy test via Allergist or Immunologist following an anaphylaxis reaction or if you are at high risk for allergies

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Hammett, E. (2022, May 26). Food allergies and anaphylaxis. Online First Aid. https://onlinefirstaid.com/food-allergies-and-anaphylaxis/

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Harding, M., Kwong, J., Roberts, D., Hagler, D., Reinisch, C., Hoy, H., & Ng, Y. C. (2020). Chapter 13 Immune Responses and Transplantation. In Lewis's medical-surgical nursing: Assessment and management of clinical problems (11th ed., pp. 194–195). essay, Elsevier, Inc.

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Huether, S., McCance, K., & Rote, N. S. (2019). Chapter 9 Alterations in Immunity and Inflammation. In Pathophysiology: The Biologic Basis of Disease in Adults and Children (8th ed., pp. 256–257). essay, Elsevier.

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Nationwide Children's Hospital. (2022). How to Use An EpiPen. https://www.nationwidechildrens.org/family-resources-education/health-wellness-and-safety-resources/resources-for-parents-and-kids/how-to-use-an-epipen

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Pflipsen, M. C., & Vega Colon, K. M. (2020). Anaphylaxis: Recognition and Management. American family physician, 102(6), 355–362.

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This video provides clear instructions on how to utilize the EpiPen so users of all ages can follow the steps. It also shows the location and demonstration for the insertion of the EpiPen. By providing knowledge of this skill, it can be a matter of life or death for an individual.

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YouTube. (2021). Anaphylaxis, Animation . YouTube. Retrieved October 5, 2022, from https://www.youtube.com/watch?v=5Sn4bi3t7YE.

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Vaillant, A. A. J., Vashisht, R., & Zito, P. M. (2022, January). Immediate Hypersensitivity Reactions. NIH National Library of Medicine. https://pubmed.ncbi.nlm.nih.gov/30020687/