El pediatra de Atención Primaria y la anafilaxia

María Teresa Ferrer Guerra, L. Martínez, Juan Carlos Juliá, Isabel Reig, Gvr Grupo de Vías Respiratorias (GVR)
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Abstract

Anaphylaxis is a severe, rapid and potentially fatal allergic reaction. The diagnosis of anaphylaxis is clinical and must be early. It appears in the first 2 hours after exposure to the allergen, in the first 30 minutes in food allergy and earlier with intravenous drugs or hymenoptera stings. Cutaneous symptoms are generally the first to appear and are present in most cases, more than 80%. They may be mild or transitory, or absent in 18% of cases. If the cardio-circulatory system is affected, an anaphylactic shock occurs. The most frequent cause in pediatrics is nutrition. There are several cofactors whose presence increases the likelihood of anaphylaxis; the most important are: exercise, medication, fever and stress. The treatment of choice is intramuscular adrenaline. Parents and children should be able to identify the signs and/or symptoms of anaphylaxis in order to implement the treatment prescribed in the written action plan.
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儿科初级保健医生与过敏性休克
过敏性休克是一种严重、迅速且可能致命的过敏反应。过敏性休克的临床诊断必须尽早。过敏性休克会在接触过敏原后 2 小时内出现,食物过敏会在 30 分钟内出现,静脉注射药物或膜翅目昆虫蛰伤会更早。皮肤症状通常最先出现,在大多数病例中都会出现,超过 80%。皮肤症状可能比较轻微或短暂,也有 18% 的病例没有皮肤症状。如果心脏循环系统受到影响,就会出现过敏性休克。儿科最常见的病因是营养。有几种辅助因素会增加过敏性休克发生的可能性,其中最重要的是:运动、药物、发烧和压力。首选治疗方法是肌肉注射肾上腺素。家长和儿童应能够识别过敏性休克的体征和/或症状,以便实施书面行动计划中规定的治疗。
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