As spring arrives and flowers bloom, beware of animal injuries that may cause anaphylactic shock

Spring is here,

Various insects also began to become active.

Stay away from insects when you go out.

To avoid being stung or bitten.

Recently, media reported that

A Brazilian athlete was riding a bicycle.

A bee lodged itself in his throat.

He died of anaphylactic shock.

Many people find it incredible.

Can a bee kill someone ?

Analyzing this news, we can infer that it is very likely that the athlete was stung by a bee that accidentally entered his mouth and became frightened.

The seemingly minor stings triggered a serious allergic reaction in the body, causing the victim to suffer anaphylactic shock and eventually die due to untimely rescue. Therefore, when going out for fun in spring, do not ignore bee stings, tick bites, ant stings and other commonly thought "minor injuries", because there is a hidden "killer" behind them - anaphylactic shock .

1

What is anaphylactic shock?

When certain allergens (such as insect venom) enter the human body, they will quickly trigger an IgE-mediated immune response, causing mast cells or basophils to activate and degranulate, releasing pre-synthesized mediators (such as histamine), enzymes (such as tryptase), and cytokines. These mediators can directly act on tissues, causing allergic symptoms, and can also recruit and activate other inflammatory cells, releasing more mediators and promoting explosive "chain reactions", acting on multiple systems or organs, causing systemic allergic reactions.

When the systemic allergic reaction worsens, causing a significant decrease in effective circulating blood volume, ischemia and hypoxia of tissues and organs, anaphylactic shock will occur. Anaphylactic shock can progress quickly and endanger life within a few minutes. However, if treated in time, there is a high chance of recovery .

2

What are the causes of anaphylactic shock?

In recent years, studies have found that the incidence of anaphylactic shock is gradually increasing worldwide. The causes of anaphylactic shock vary significantly by region. For example, the most common causes in Europe and the United States are nuts, peanuts, fish, and shellfish; the most common cause in the United States is peanuts; the leading cause in Sweden is bee venom; the common causes in Japan and South Korea are buckwheat and wheat; and in Singapore, it is bird's nest.

A retrospective study in China found that about 85% of anaphylactic shocks have clear causes . Overall, food causes accounted for 77%, drug causes accounted for 7%, and insect causes ranked third, accounting for about 0.6%. In fact, among animal injuries, it is not only insect bites and stings that can cause anaphylactic shock. Other animals, such as jellyfish and stonefish, can also cause anaphylactic shock after injuries. In addition, the study also found that exercise, drinking and taking antipyretic and analgesic drugs are the most common aggravating factors for anaphylactic shock.

3

What are the symptoms of anaphylactic shock?

Anaphylactic shock can manifest in a variety of ways, usually with the following symptoms appearing suddenly within minutes to hours of exposure to the allergen:

1. Skin and mucous membrane manifestations, generalized urticaria, itching or flushing, laryngeal edema, conjunctival swelling, etc.;

2. Respiratory system manifestations, including changes in pronunciation, cyanosis of the lips, suffocation, stridor, rapid breathing, wheezing, coughing, etc.;

3. Cardiovascular system manifestations, including syncope, pale complexion, cold limbs, tachycardia, hypotension, etc.;

4. Digestive system manifestations: spasmodic abdominal pain, nausea, vomiting, etc.

The most serious patients may experience respiratory and cardiac arrest .

4

How to treat anaphylactic shock

The key to treating anaphylactic shock is early identification. Once you have come into contact with a suspected allergen (such as an insect bite or sting) and the above symptoms appear, you must not be careless, be highly alert to the possibility of anaphylactic shock, conduct on-site first aid as soon as possible, and transfer to a medical institution for diagnosis and treatment as soon as possible.

1. Immediately get away from allergens, such as removing remaining bee stings while avoiding squeezing, scraping off remaining jellyfish stinging sacs with a card, etc.

2. Keep the patient in a supine position, slightly raise the head and lower limbs. If vomiting occurs, the patient's head should be tilted to one side to avoid suffocation caused by vomitus.

3. If the patient experiences respiratory or cardiac arrest, cardiopulmonary resuscitation should be started immediately.

4. If adrenaline is available, inject it intramuscularly as soon as possible.

5. Keep the airway open and give oxygen through a mask. If laryngeal edema occurs, endotracheal intubation should be performed as soon as possible.

6. Open multiple intravenous accesses as soon as possible and quickly infuse normal saline.

7. Use auxiliary drugs, such as antihistamines, bronchodilators, glucocorticoids, vasoactive drugs, etc.

8. Keep the patient in hospital for observation or treatment, and closely monitor the patient's vital signs.

Special note: Epinephrine should not be injected subcutaneously because it is absorbed slowly. Hormones should not be used as the first-line treatment for severe allergic reactions.

Finally, I would like to remind everyone that when going out for fun, you should stay away from animals that may cause anaphylactic shock after injury, and take protective measures before possible contact. For example, you should wear long-sleeved clothes when entering a woods with dense vegetation, and wear a jellyfish-proof swimsuit when swimming in the sea.

Once injured by an animal, you should immediately get away from the animal, remove foreign objects (such as bee stings) remaining in the wound, wash the wound with clean water, and seek medical attention promptly.

Source: Healthy China

Author: Liu Yun and Liu Si, Emergency Department, Peking University First Hospital

Reviewer: Wang Chuanlin, expert of the National Health Science Expert Database, deputy director of the Department of Emergency Surgery and deputy director of the Trauma Treatment Center of Peking University People's Hospital