Providing emergency care for anaphylactic shock. Emergency care for cardiogenic shock, algorithm

For allergy sufferers, the most dangerous manifestation of pathology is anaphylactic shock. With the development of this condition, patients must be provided with emergency assistance, otherwise everything will end fatally for them. Each person should know how to act correctly in such a situation in order to save the life of the patient before the ambulance arrives.

Allergic shock modern medicine refers to the reactions of the body of an instantaneous type. It develops in patients with a tendency to allergies, with primary or secondary exposure to a factor that provokes a pathological condition. Due to the rapid development of anaphylactic shock, people need to follow the algorithm of actions exactly in order to have time to save the life of the sick.

Signs of anaphylactic shock and emergency care

There are several stages in the course of this dangerous condition:

1. Lightning. The patient rapidly develops vascular, respiratory and cardiac failure. Despite the measures taken, in 90% of cases it is not possible to save the life of patients.
2. lingering. Shock in allergy sufferers develops against the background of the introduction of drugs prohibited for them. In this case, intensive therapy is carried out, the duration of which is several days (it all depends on the condition of the patient, who must be under the supervision of specialists all the time).
3. Abortive. With the development of this variant of allergic shock, there is no threat to the life of patients. This condition can be quickly stopped with the help of special medicines.

With the development of recurrent anaphylactic shock in patients, a pathological condition may recur, since their body is periodically affected by unknown allergens.

Specialists classify such episodes as follows:

1. « Harbingers". The patient may feel dizzy and weak throughout the body. Very quickly he develops nausea and headache. A large number of patients on the mucous membranes and on the skin manifest various kinds of allergic manifestations. There is discomfort and anxiety. The patient may complain that he has nothing to breathe, hearing loss, loss of vision, numbness of the limbs.
2. « Razgar". An allergic person's blood pressure drops rapidly, which can cause him to lose consciousness. The skin becomes painfully pale, tachycardia develops, sticky cold sweat appears. A person begins to breathe noisily, cyanosis of the extremities and lips develops, severe itching appears. Problems begin with the release of urine, there may be a relief of this process, or vice versa, incontinence.
3. « Getting out of shock". This stage of anaphylaxis can last for several days. All this time, an allergic person will have characteristic symptoms: weakness, lack (partial or complete) of appetite, severe dizziness.

Modern medicine has identified 5 clinical forms of this pathological condition:

First aid for anaphylactic shock

There is the following algorithm of actions in the development of a shock state in allergy sufferers:

1. The patient must be placed on the surface of the floor, table, sofa, etc. A folded blanket or other object should be placed under the legs so that they are in an elevated state.
2. To prevent the penetration of vomit into the respiratory tract, the patient's head should be turned to one side. If he has dentures instead of his own teeth, then they must be removed from his mouth.
3. If the attack occurred indoors, then fresh air should be provided into it. You can immediately open both doors and windows.
4. The person who provides first aid must stop the contact of the patient with the allergen.
5. It is necessary to count the pulse. If it is not palpable on the wrist, you should try to find it on the femoral or carotid artery.
6. In the event that an allergic person could not find a pulse, an urgent need to conduct a heart massage (indirect). This is done as follows: the hands are folded into a lock, after which, in this position, they lie on the sternum (on the middle part). Next, you need to rhythmically perform pushes (their depth should not exceed 4-5 cm).
7. The breath of an allergic person is checked. If the movements of the chest are imperceptible, then you need to attach a mirror to his mouth, which, if present, will fog up. In the event that there is no breathing, the person providing emergency assistance should put a handkerchief (napkin) on the area of ​​\u200b\u200bthe mouth or nose and inhale air through it.
8. Next, you need to call an ambulance or transport the patient on your own to the nearest medical facility. Before the arrival of specialists, you can give the victim an antihistamine, or give an injection of adrenaline intramuscularly.

Emergency medical care for anaphylactic shock

In order to provide assistance to the victim as soon as possible, specialists must urgently carry out diagnostic measures. To differentiate this condition from other pathologies, doctors should take a proper history. A blood test, radiography, kidney tests, enzyme immunoassay, and allergological tests are also done.

Medical care for anaphylactic shock is carried out as follows:

1. The specialist first of all measures the pressure of an allergic person and checks his pulse rate.
2. After that, oxygen saturation is determined, electrocardiography is performed.
3. To ensure airway patency, a specialist needs to act as follows. If the state of shock is accompanied by a gag reflex, then the remains of the vomit should be removed from the oral cavity. The jaw (lower) is removed using the Safar triple technique. Tracheal intubation is performed.
4. If the victim has Quincke's edema or a spasm of the fissure (voice) has occurred, then the doctor should perform a conicotomy. This manipulation involves making an incision in the larynx. This is done in a place that is located between two types of cartilage (we are talking about the cricoid and the thyroid). It is done so that air can flow to the lungs of the victim. The doctor may decide to perform a tracheotomy. This manipulation can be carried out only in a hospital, as specialists will need to carry out the most accurate dissection of the tracheal rings.

What medications are administered for anaphylactic shock?

The introduction of medicines in the development of a shock state in allergic people should be carried out only by a person with a medical education:

1. Adrenalin. Before the injection, a solution is made: 1 ml of adrenaline hydrochloride (0.1%) is mixed with physical. solution (10 ml). In the case when the pathological condition of the patient was caused by an insect bite, then this place should be pricked with diluted adrenaline (injections are made subcutaneously). After that, up to 5 ml of this solution is administered intravenously (sublingual administration is allowed, under the root of the tongue). The remaining diluted adrenaline is injected into a vial with saline. solution (200 ml) and should be administered to the patient by drip (intravenously). In parallel, the doctor must constantly monitor the pressure.
2. Glucocorticosteroids. In most cases, specialists administer to allergic patients with shock Prednisolone (9-12 mg) or Dexamethosone (12-16 mg).
3. Antihistamines. At first, patients are given injections of Tavegil, Suprastin or Dimedrol. Over time, they are transferred to the tablet form of drugs.
4. 40% oxygen inhalations (humidified). The rate of administration should not exceed 7 liters per minute (from 4 liters).
5. Methylxanthines. Introduced in case of respiratory failure (severe). Doctors administer aminofillin (5-10 ml), methylxanthines (2.40%).
6. Solutions (crystalloid and colloid). They are administered to patients with acute vascular insufficiency.
7. Diuretic drugs. They are prescribed to prevent cerebral edema. For example, Minnitol, Furasemide.
8. Anticonvulsants. Shown for use in the development of the cerebral form of pathology.

Effects

After removing the victim from the state of anaphylactic shock, in particular after stopping vascular and heart failure, the following symptoms may persist for a long time period:

1. Fever (chills).
2. Lethargy.
3. Pain in the abdomen or heart, as well as in the muscles and joints.
4. Lethargy.
5. Dyspnea.
6. Weakness.
7. Nausea.
8. Vomiting reflex.

Preventive actions

To prevent the possibility of developing anaphylactic shock, allergy sufferers should carry out appropriate prevention:

1. First of all, contact with allergens should be avoided.
2. Bad habits should be abandoned.
3. If drug therapy is carried out, then you need to make sure of their quality.
4. It is recommended to change the place of residence if the apartment or house is located in an ecologically unfavorable area.
5. It is necessary to timely treat diseases that have an allergic etiology.
6. Patients must observe personal hygiene.
7. The living quarters should be regularly cleaned and ventilated.

The most dangerous consequences of anaphylactic shock are loss of consciousness and death of the patient.

Anaphylactic shock is the most severe and dangerous manifestation of an allergic reaction. This condition threatens the life of the patient, so first aid for anaphylactic shock should be timely, since it is vital.

Anaphylaxis is the result of an inadequate reaction of the human immune system in response to the entry of an allergen into the body. Allergic shock is superstrong and develops instantly.

It is quite dangerous if anaphylaxis affects the functioning of the respiratory and cardiovascular systems. A person can die from suffocation or cardiac arrest.

Symptoms of anaphylactic shock

Symptoms affect - the respiratory and cardiovascular system, gastrointestinal tract and skin:

• skin rash and severe itching;
• swelling of the mucous membranes, resulting in lacrimation, runny nose and more;
• swelling and spasms of the throat, difficulty breathing;
• lowering blood pressure, increased heart rate;
• nausea and vomiting;
• convulsions;
• loss of consciousness.

Signs of anaphylactic shock may appear within 1-30 minutes. after exposure to the allergen. The reaction to food develops in 10-30 minutes, but to insect bites - within a few minutes.

Signs of manifestation in children

In newborns and children, anaphylaxis appears suddenly:

• weakness and drowsiness;
• increased sweating;
• pallor of the skin;
• increased heart rate, a feeling of tightness in the chest;
• respiratory failure;
• capriciousness, feeling of fear.

The child urgently needs medical attention, since the allergic reaction develops quickly, he can die within a couple of minutes after the onset of the first symptoms.

Save the life of the sick

Providing first aid to patients with anaphylaxis is necessary with minimal manifestations of allergies. The patient necessarily needs hospitalization and resuscitation.

How to help before the doctor arrives

Before the ambulance arrives, the algorithm of emergency care for anaphylactic shock looks like this.

Action	Description
	At the first symptoms, call an ambulance.
	Eliminate the effect of the allergen: turn off the dropper, if the medicine was injected, be sure to apply a tourniquet above the injection site. For insect bites, treat the wound with an anesthetic, such as "Rescuer".
	Give the patient an antihistamine, such as Fenkarol or Suprastin.
	Lay the victim on a horizontal surface so that the legs are above the level of the head. Make sure that the patient does not swallow the tongue if convulsions appear. Turn your head to the side. The position of the patient can be seen in the photo.
	Measure the pulse and monitor the pressure. If there is no breathing or pulse, then first aid looks like this: do an indirect heart massage before the doctor arrives. • Artificial respiration may not be effective if the airways are swollen.

The actions of health workers in anaphylactic shock

To help with anaphylaxis, the doctor should have a first aid kit with him. Its composition was approved by law in 2014.

The emergency kit looks like this:

• "Adrenalin";
• "Prednisolone";
• antihistamines, such as Hydrocortisone or Suprastin;
• "Eufillin";
• "Dimedrol".

Important. Drugs such as gluconate or calcium chloride can give a negative reaction.

Medicines from the kit must be used immediately. The sooner the reaction is stopped, the lower the likelihood of severe consequences.

Doctors begin to provide emergency medical care with the introduction of a solution of "Adrenaline" subcutaneously or intravenously.

The instructions for providing medical care look like this:

Preparations	Action Description
	Enter "Adrenaline"
	Glucocorticoids are used for anti-edematous and anti-allergic action. The effect lasts up to 4 hours.
	Dimedrol or Tavegil is administered to accelerate the antiallergic action of glycocorticoids.
	With spasm of the bronchi, you will need "Eufillin".

The algorithm for providing emergency care in dentistry is similar. Anaphylactic shock can develop when anesthetics are used during surgery or surgical treatment. If necessary, the administration of medications is repeated every 15 minutes until the patient feels better. Children are shown a lower dose of drugs compared to adult patients.

Learn more about helping in the video accompanying this article.

What causes anaphylactic shock

The causes of anaphylaxis in children and adults are the same:

• insect bites;
• the development of shock with intravenous administration of the drug;
• food allergy (milk, nuts, honey and others);
• exposure to an allergen through the respiratory tract (for example, inhalation of pollen).

Of the medications, anaphylaxis is most often caused by ICE inhibitors, penicillin preparations, vaccines, and anesthesia.

Preventive measures

Prevention can save lives:

• Give your doctor a list of medications you are allergic to in advance.
• Avoid insect bites.
• Take antihistamines regularly if you have seasonal allergies to pollen, cold, heat, etc.
• Watch what you eat. If you eat out, check out the ingredients of the dish.

First aid for anaphylactic shock should be provided within a few minutes, so keep a first aid kit at home with all the necessary drugs. Carry antihistamines with you so that you can be helped outside the home.

Anaphylactic shock is one of the most severe immediate allergic reactions and is a response to the repeated introduction of an allergen into the body. This is a very dangerous condition, which in 10% of cases ends in death. The prevalence of pathology reaches 5 cases per hundred thousand of the population during the year. Young people are more susceptible to it.

Each of us should know the algorithm of actions for anaphylactic shock. After all, if first aid for anaphylactic shock is provided in a timely manner, you can save a person from death.

For the first time, the term "anaphylactic shock" was proposed in 1913 by the French scientist Charles Richet, who received the Nobel Prize for his research on this phenomenon. Pathology can develop in a period from a few seconds to 5 hours after contact with the allergen. The more irritant enters the human body, the harder and longer the shock reaction proceeds. However, the dose and method of administration of the substance do not play a decisive role in the occurrence of this condition.

An important role in the occurrence of a shock reaction is played by a hereditary tendency to allergic reactions. Most often it develops with repeated administration of the drug. But in those people who previously could have had indirect contact with the allergen (doctors, children whose mothers took medication during pregnancy and breastfeeding), it may occur during the first application.

The most common causes of anaphylactic shock are:

• oral or parenteral administration of antibiotics, anesthetics, immune sera and other medicinal substances;
• transfusion of blood or its substitutes;
• the introduction of radiopaque substances for diagnostic purposes;
• conducting skin tests with allergens;
• vaccination;
• food allergens;
• insect bites;
• cold reaction.

Development mechanism

The decisive role in the occurrence of this pathological condition is played by class E immunoglobulins (reagin antibodies), which are formed in the body at the very first contact with the allergen. With repeated administration, irritants bind to antibodies, forming immune complexes. Circulating through the bloodstream, they settle on the surface of cell membranes, destroying them. At this moment, biologically active substances leave the cells, which further cause symptoms of anaphylactic shock.

Clinical picture

The first symptom of the disease is usually a pronounced reaction that occurs at the injection site. It manifests itself in the form of pain, swelling, redness, swelling, itching. If the drug was taken orally, nausea, abdominal pain, diarrhea, swelling of the larynx appear.

There are 5 clinical forms of this disease:

• typical;
• hemodynamic, which is manifested by heart failure, arrhythmia, decreased pressure, marbling of the skin;
• asphyxic, accompanied by bronchospasm, swelling of the larynx;
• cerebral, which is characterized by excitement and convulsions;
• abdominal, having symptoms similar to an acute abdomen.

The most characteristic signs of anaphylactic shock are:

• A sharp decrease in pressure up to collapse.
• Loss of consciousness or confusion, convulsions, agitation, dizziness.
• The skin is pale, bluish, covered with sticky sweat.
• The appearance of rashes on the skin in the form of urticaria.
• Swelling of the tissues of the face, neck, torso.
• Redness of the face.
• Nausea, abdominal pain.
• Bronchospasm, which is accompanied by fear of death, shortness of breath, tightness in the chest and a feeling of lack of oxygen.

Consequences of anaphylactic shock

Emergency care for anaphylactic shock should be provided when the first symptoms appear, as it can lead to the death of the victim. When this condition occurs, all body systems suffer. If a person has a second shock reaction, it is much more severe than the first time.

The consequences of anaphylactic shock can occur in the form of disorders of the heart, nervous system, vestibular apparatus, the appearance of jaundice, glomerulonephritis.

Treatment

An ambulance for anaphylactic shock must be called even with minimal allergy symptoms, which are accompanied by a decrease in blood pressure and a change in pulse. Patients need immediate hospitalization in intensive care, where they will be provided with qualified medical care for anaphylactic shock.

First aid for anaphylactic shock should be provided immediately before the arrival of the ambulance team and include the following:

• Eliminate exposure to the allergen: ventilate the room, stop the administration of the drug, apply a tourniquet above the injection or bite site, treat the wound with an antiseptic, apply cold.
• Lay the victim horizontally, with a decrease in pressure with slightly raised legs, turn his head to one side, push the lower jaw, remove dentures from his mouth.
• Monitor the pulse, pressure, breathing of the patient.
• Make him take an antihistamine that is available (tavegil, suprastin, fenkarol).
• After the arrival of the doctors, provide them with information about the exact time of the onset of the reaction, symptoms, assistance provided, anamnesis, if known.

Emergency assistance for anaphylactic shock, which is provided by the ambulance team at the scene, includes the following activities:

• All drugs are administered intravenously or intramuscularly.
• The injection site of the substance that caused the allergy is cut off with a 0.1% solution of adrenaline in an amount of 1 ml. If there is no increase in blood pressure, it is administered again at a dose of 0.5 ml.
• Glucocorticosteroid hormones: prednisolone 1-2 mg/kg of the patient's weight, hydrocortisone 150-300 mg.
• Assistance with anaphylactic shock includes the introduction of antihistamines: 2% solution of suprastin 2 ml, 1% diphenhydramine 5 ml.
• Bronchospasm is stopped by the introduction of a 24% solution of eufillin 2 ml.
• Heart failure is eliminated with diuretics (diacarb, lasix, furosemide) and cardiac glycosides (digoxin, strophanthin).
• If anaphylactic shock is caused by the use of penicillin, the enzyme penicillinase is used in an amount of 1 million units.
• Frees the airways from mucus.
• Oxygen is given through a nasal catheter.

Anaphylactic shock is one of the most severe immediate allergic reactions and is a response to the repeated introduction of an allergen into the body. This is a very dangerous condition, which in 10% of cases ends in death. The prevalence of pathology reaches 5 cases per hundred thousand of the population during the year. Young people are more susceptible to it. Each of us should know the algorithm of actions for anaphylactic shock. After all, if first aid for anaphylactic shock is provided in a timely manner, you can save a person from death.

For the first time, the term "anaphylactic shock" was proposed in 1913 by the French scientist Charles Richet, who received the Nobel Prize for his research on this phenomenon. Pathology can develop in a period from a few seconds to 5 hours after contact with the allergen. The more irritant enters the human body, the harder and longer the shock reaction proceeds. However, the dose and method of administration of the substance do not play a decisive role in the occurrence of this condition.

Causes of anaphylactic shock

An important role in the occurrence of a shock reaction is played by a hereditary tendency to allergic reactions. Most often it develops with repeated administration of the drug. But in those people who previously could have had indirect contact with the allergen (doctors, children whose mothers took medication during pregnancy and breastfeeding), it may occur during the first application.

The most common causes of anaphylactic shock are:

- ingestion or parenteral administration of antibiotics, anesthetics, immune sera and other medicinal substances;
- transfusion of blood or its substitutes;
- the introduction of radiopaque substances for diagnostic purposes;
- Carrying out skin tests with allergens;
- food allergens;
- insect bites;
- reaction to cold.

Development mechanism

The decisive role in the occurrence of this pathological condition is played by class E immunoglobulins (reagin antibodies), which are formed in the body at the very first contact with the allergen. With repeated administration, irritants bind to antibodies, forming immune complexes. Circulating through the bloodstream, they settle on the surface of cell membranes, destroying them. At this moment, biologically active substances leave the cells, which further cause symptoms of anaphylactic shock.

Clinical picture

The first symptom of the disease is usually a pronounced reaction that occurs at the injection site. It manifests itself in the form of pain, swelling, redness, swelling, itching. If the drug was taken orally, nausea, abdominal pain, diarrhea, swelling of the larynx appear. There are 5 clinical forms of this disease:

- typical;
- hemodynamic, which is manifested by heart failure, arrhythmia, decreased pressure, marbling of the skin;
- asphyxic, accompanied by bronchospasm, swelling of the larynx;
- cerebral, which is characterized by excitement and convulsions;
- abdominal, having symptoms similar to an acute abdomen.

The most characteristic signs of anaphylactic shock are:

- A sharp decrease in pressure up to collapse.
- Loss of consciousness or confusion, convulsions, agitation, dizziness.
- The skin is pale, bluish, covered with sticky sweat.
- The appearance of rashes on the skin in the form of urticaria.
- Swelling of the tissues of the face, neck, torso.
- Redness of the face.
- Nausea, abdominal pain.
- Bronchospasm, which is accompanied by fear of death, shortness of breath, tightness in the chest and a feeling of lack of oxygen.

Consequences of anaphylactic shock

Emergency care for anaphylactic shock should be provided when the first symptoms appear, as it can lead to the death of the victim. When this condition occurs, all body systems suffer. If a person has a second shock reaction, it is much more severe than the first time. The consequences of anaphylactic shock can occur in the form of disorders of the heart, nervous system, vestibular apparatus, the appearance of jaundice, glomerulonephritis.

Treatment

An ambulance for anaphylactic shock must be called even with minimal allergy symptoms, which are accompanied by a decrease in blood pressure and a change in pulse. Patients need immediate hospitalization in intensive care, where they will be provided with qualified medical care for anaphylactic shock. First aid for anaphylactic shock should be provided immediately before the arrival of the ambulance team and include the following:

- Eliminate exposure to the allergen: ventilate the room, stop the administration of the drug, apply a tourniquet above the injection or bite site, treat the wound with an antiseptic, apply cold.

Lay the victim horizontally, with a decrease in pressure with slightly raised legs, turn his head to one side, push the lower jaw, remove dentures from his mouth.

Monitor the pulse, pressure, breathing of the patient.

Make him take an antihistamine that is available (tavegil, suprastin, fenkarol).

After the arrival of the doctors, provide them with information about the exact time of the onset of the reaction, symptoms, assistance provided, anamnesis, if known.

Emergency assistance for anaphylactic shock, which is provided by the ambulance team at the scene, includes the following activities:

- All drugs are administered intravenously or intramuscularly.

The injection site of the substance that caused the allergy is cut off with a 0.1% solution of adrenaline in an amount of 1 ml. If there is no increase in blood pressure, it is administered again at a dose of 0.5 ml.

Glucocorticosteroid hormones: prednisolone 1-2 mg/kg of the patient's weight, hydrocortisone 150-300 mg.

Assistance with anaphylactic shock includes the introduction of antihistamines: 2% solution of suprastin 2 ml, 1% diphenhydramine 5 ml.

Bronchospasm is stopped by the introduction of a 24% solution of eufillin 2 ml.

Heart failure is eliminated with diuretics (diacarb, lasix, furosemide) and cardiac glycosides (digoxin, strophanthin).

If anaphylactic shock is caused by the use of penicillin, the enzyme penicillinase is used in an amount of 1 million units.

Oxygen is given through a nasal catheter.

The algorithm for helping with anaphylactic shock provides for the repeated administration of medications every 15 minutes until the desired effect occurs.

Resuscitation actions in anaphylactic shock include artificial respiration, closed heart massage, tracheostomy, artificial lung ventilation, central vein catheterization, injection of adrenaline into the heart. After the elimination of acute phenomena, the victim must undergo desensitizing therapy for another 2 weeks.

Anaphylactic shock (AS) is a generalized form of an allergic reaction characterized by dysfunction of vital organs (nervous, endocrine, cardiovascular, excretory, respiratory systems). AS occurs as a result of re-entry of the allergen into the body, it develops rapidly, it is very important to provide assistance immediately.

What are the causes of AS (anaphylaxis)?

A variety of allergens can trigger anaphylaxis. After re-entering the body, the allergen meets antibodies on its way, as a result of which a large amount of histamine is released into the blood at lightning speed. This in turn leads to disruption of all vital functions of the body.

The most common causes of anaphylactic shock are:

• bites of membranous insects and snakes;
• medications;
• the use of antibiotics;
• vitamins (group B);
• local anesthetics;
• blood products and blood components;
• odorous gaseous substances;
• iodine-containing contrast agents;
• food products (eggs, seafood, nuts, citrus fruits, gluten, fish, chocolate, etc.)

In the development of the clinical picture of AS, based on the time of manifestation of symptoms and the severity of their course, several forms of anaphylaxis are distinguished. The instantaneous form progresses in the first minutes after contact with the stimulus. This can usually be an injection of a drug. It is characterized by circulatory dysfunction. In this case, there is a maximum risk of death. Severe form - the development of symptoms up to 10 minutes. Moderate shock develops in 15-20 minutes.

Forms. According to clinical manifestations, several forms of anaphylactic shock are distinguished:

• cardiac form. Characterized by marbled skin, hypotension, thready pulse, palpitations, arrhythmia.
• Asthmatic. There is a sudden onset of suffocation.
• Cerebral. Violation of cerebral circulation develops sharply (nausea, vomiting, convulsions, involuntary urination and defecation).
• Gastrogic. Manifested by the syndrome of "acute abdomen".
• mixed form. There may be various manifestations of functional disorders of the body.

AS begins with a sharp general weakness, dizziness, nausea, a feeling of heat, chest compression, an asthma attack, pain in the epigastric region. Seizures may develop and fainting may occur. There are: pallor or cyanosis of the skin, cold sweat, cold extremities, collapsed veins, dilated pupils, convulsions, fainting.

It is very important to provide emergency care to a person with anaphylaxis immediately when initial symptoms occur. The main sign of the onset of the development of AS is a sharp drop in blood pressure, difficulty breathing and loss of consciousness. Why is this happening? Upon contact with the allergen in the blood, a sharp release of inflammatory mediators occurs. They relax blood vessels, narrow the bronchi, give characteristic skin reactions in the form of swelling and rash.

What first emergency medical care should be provided before the doctor arrives? Action algorithm:

1. Lay the patient on a horizontal surface. Turn the head to one side to avoid asphyxia with vomit. The head should be below the legs.
2. If the cause was the injection of the drug, then immediately stop the injection, leaving the needle and removing only the syringe with the drug.
3. Apply a tourniquet above the injection in order to limit the further spread of the drug and chop the injection site with an adrenaline solution.
4. Loosen tight clothing to let fresh air into the room.
5. If the cause of AS was an insect bite, then an ice pack should be applied to the site of the bite. Apply cold to the injection site.
6. Enter adrenaline and hormones.
7. Call a doctor as soon as possible. It is better if this is done immediately to a person who is not busy providing medical assistance to the victim.