Emergency care for angioedema and disease prevention

Quincke's edema is a dangerous condition that usually appears due to the reaction of the immune system to some irritant. It can be triggered by foods to which a person is allergic, as well as hereditary factors. In case of Quincke's edema, it is important to provide first aid to the victim quickly, otherwise a specific reaction can be fatal.

Typically, Quincke's edema appears due to the reaction of the immune system to some irritant.

Causes

The appearance of Quincke's edema is associated with various factors. Most often, the condition is provoked by the development of allergies. Angioedema occurs due to food or other allergens:

Reaction to household chemicals.

• nuts, some fruits (citrus fruits, kiwi), eggs, honey, chocolate;
• food additives (artificial colors, flavors, preservatives);
• medical supplies;
• pollen;
• pet hair;
• when an insect bites, lymphedema develops;
• household chemicals;
• dust.

Edema often occurs due to heredity. In this case, its appearance is provoked by stressful conditions, infections, injuries, operations (including dental ones), the period of gestation, as well as the use of oral contraceptives.

Acquired angioedema occurs in certain diseases. Chronic lymphocytic leukemia, lymphosarcoma, myeloma and other neoplasms accompany the manifestation of edema.

Kinds

Depending on whether the edema is acquired or congenital, there are several types of it:

Quincke's edema may be accompanied by urticaria.

• allergic. Appears upon contact with allergens. Hives and other symptoms, including itching, also occur. The swelling lasts 1 – 2 days;
• hereditary. Not accompanied by urticaria. It occurs if someone in the family has already had cases of shock. The first signs occur in childhood and progress further;
• acquired edema. Associated with a decrease in inhibitor C. An uncontrolled release of active components occurs;
• swelling associated with taking ACE inhibitors (usually included in medications intended to normalize blood pressure). The production of specific enzymes decreases. The first symptoms appear 1 week after the start of treatment;
• uncertain. With this type of Quincke's edema, the reaction appears for no reason. Most often it occurs in women and is accompanied by urticaria.

Symptoms

When the first signs appear, you should not hesitate. Emergency assistance for Quincke's edema must be provided within a few minutes. You can understand that a dangerous condition is developing by the following symptoms:

• the respiratory organs (larynx) swell. As a result, hoarseness of the voice appears, coughing, breathing becomes heavy;
• skin color changes at the site of contact with the allergen (allergic type). First it turns blue, then pales;
• convulsions and loss of consciousness are possible;
• if swelling of the genitourinary system develops, urination is difficult, but the urge becomes more frequent, and pain in the abdominal cavity also appears.

Signs of the development of a reaction depend on where exactly the swelling is localized.

On the face

Puffiness appears on the cheeks, eyes, nose, ears and lips and even the tongue.

In the facial area, puffiness appears on the cheeks, eyes, nose, ears and lips, and even the tongue. In this case, the patient practically cannot speak, his eyes open with difficulty. Outwardly, this is similar to what a person would look like after being bitten by stinging insects.

On the respiratory tract

If the symptoms of Quincke's edema are localized in the respiratory system, it is dangerous to human life and health. When the larynx swells, the supply of oxygen is reduced, since the victim is practically unable to take a breath. With this type of shock, a cough appears, the voice becomes barely audible, and shortness of breath occurs. The face turns blue, the person loses consciousness.

A cough appears, the voice becomes barely audible, and shortness of breath occurs.

In the absence of first aid for Quincke's edema, death will occur. With prolonged respiratory failure, edema leads to pathological disorders of brain activity.

On internal organs

When puffiness is localized to internal organs, victims note nausea, vomiting, intestinal upset, excessive dryness of the mucous membranes in the mouth, as well as pain in the abdominal area. There is a feeling of tension in the abdomen. With this type, an incorrect diagnosis is possible, so mandatory hospitalization of the person in a medical institution is required.

Algorithm for emergency care for angioedema

Regardless of where the tumor is localized (internal organs, oropharynx area), the algorithm of actions in the medical field will be approximately the same. If you notice the first symptoms of swelling, call an ambulance immediately. Until doctors arrive, first aid for angioedema in adults includes the following steps:

1. if a dangerous condition arises due to contact with an allergen, it should be stopped immediately;
2. calm the person down. Victims usually go into shock, which only worsens the condition. Explain that the doctors will arrive soon and everything will be fine;
3. Help the person find a comfortable position.
   Usually he is placed on his back. Loosen your tie or collar if they interfere with breathing; Lay the person down and allow him to breathe.
4. If you are indoors, take the victim outside or open a window to provide fresh air;
5. The victim should be given an antihistamine tablet or an injection.
   If you are prone to allergic edema, the first aid kit should have special means to prevent the development of edema; Antihistamines for Quincke's edema.
6. Provide plenty of fluids if the patient is able to swallow (it is best if the drink is alkaline, such as mineral water);
7. Sorbents help reduce the allergen concentration.
   You can use the classic drug - activated carbon; Charcoal helps reduce allergen concentrations.
8. relieve the unpleasant symptoms of Quincke's edema with cold compresses, but act carefully so as not to provoke hypothermia;
9. place your feet in a warm bath or simply wrap them tighter;
10. If there are vasoconstrictor drops, drop them into the nasal sinuses for swelling.

How to relieve angioedema at home?

When angioedema occurs, the question arises - what to do before the ambulance arrives, and how to help the person. To help a victim of Quincke's edema at home, it is necessary to use medications that will help hold out until the medical team arrives.

The list includes antihistamines:

• Suprastin is a drug that is often prescribed for allergies, but it is important to calculate the dose correctly;
  Before taking Suprastin, be sure to check the dosage.
• Cetirizine eliminates itching and has virtually no effect on the nervous system;
• Diazolin is used in emergency cases when you need to quickly relieve symptoms. However, it has a lot of side effects, so it is not worth using on a regular basis.

During an attack, you can use sorbents. Almost every first aid kit contains activated carbon. Polysorb, Enterosgel, etc. have a good effect.

Characteristic features of first aid for children with angioedema

In cases where angioedema occurs in children, only emergency care can save lives. It is important to call an ambulance immediately and also remain calm so that the child does not become even more nervous.

Help your baby find a comfortable position (preferably lying down or reclining). Raise your legs slightly above heart level - place a pillow under them. Get rid of the allergen if a specific reaction develops due to contact with it. Use cooling compresses.

Use antihistamines for relief. Fenistil, Claritin and other drugs are produced specifically for children. Provide fluids. If the ambulance does not arrive for a long time, take the child to the hospital yourself.

Health care

Treatment of angioedema is carried out in a medical facility, but the necessary drugs can be administered at home. Doctors examine the victim, determine the degree of damage, location, and then decide on the use of medications.

Treatment of Quincke's edema is carried out in a medical facility.

The following remedies may be prescribed:

• use antihistamines to suppress histamine activity;
• if a decrease in pressure or asphyxia is recorded, an adrenaline solution is used;
• glucocorticosteroids are additionally used;
• diuretics allow you to more effectively remove the allergen due to increased urination;
• polymerase inhibitors are also prescribed.

If by the time the doctors arrive the patient has developed anaphylactic shock, an Epinephrine injection is given.

Complications and dangers

In some situations, a dangerous condition can go away on its own, but often provokes the development of serious complications:

Choking develops, coughing with wheezing begins.

• Quincke's swelling extends not only to a certain area, but also affects the respiratory system, interfering with the flow of air;
• suffocation develops, coughing with wheezing begins;
• swelling can spread to internal organs, for example, to the digestive tract;
• if the reaction spreads to the genitourinary system, the outflow of urine is disrupted and cystitis develops;
• The membranes of the brain swell, inhibition of reactions and migraines appear.

If left untreated, a person faces death.

Prevention

To reduce the risk of shock, you need to follow certain recommendations. Preventive measures include:

• diet for Quincke's edema. It is especially important to observe if you are prone to allergic reactions. Find out which foods are dangerous for you, and also make a list of possible allergens. Eat more fruits and vegetables that you are sure of, as well as porridge;
• Always study the contents of the food products you purchase in stores. Give preference to food with a minimum content of preservatives and flavorings;
• carry out wet cleaning as often as possible so that there is less dust in the air;
  Carry out wet cleaning as often as possible.
• ventilate the room at least 2 times a day, regardless of the season;
• give preference to high-quality natural materials in clothing;
• drink more clean water;
• do not take medications without consulting a doctor.

The development of Quincke's edema is one of the most serious consequences of allergies, but it can occur due to hereditary predisposition and for other reasons. In the absence of timely assistance, a person faces death. To eliminate the risk of developing a reaction, it is necessary to follow preventive measures and call an ambulance at the first symptoms.

Emergency care algorithm for angioedema Link to main publication

Source: https://stoptravma.ru/neotlozhnye-sostoyaniya/pomoshh-pri-oteke-kvinke

First aid for Quincke's edema: algorithm of actions before the ambulance arrives

string(10) "error stat"
string(10) "error stat"
string(10) "error stat"

With an allergic reaction, anyone can experience Quincke's edema. Emergency care provided to a patient in a timely manner can save life and health. We’ll look at what needs to be done in this situation in the article.

Who gets angioedema?

Many people associate allergies with commercials in which itching, burning and incessant sneezing are eliminated by taking one tablet of medicine.

In fact, allergic manifestations are much wider and more dangerous than in television life, and can lead to death. One of the manifestations of allergies is Quincke's edema or angioedema.

Unlike ordinary edema, Quincke's edema does not go away with palpation - this is a characteristic sign of the disease. Common edema appears in the morning, after waking up, and is associated with diseases of the cardiovascular system and kidney diseases.

In our case, swelling appears at any time of the day. Edema affects the limbs, face, genital and internal organs, and even the meninges. In severe cases of the disease, death may occur if assistance is not provided.

The risk group includes people with existing allergies. If we evaluate the age group of people, edema most often appears in children and young women. Typically, men and older people are less susceptible to this allergic reaction.

Reasons for the development of pathology

In order to provide qualified medical care and first aid for angioedema, you need to know its types. The disease is divided into two types.

According to the duration of the disease.

• Acute course of the disease (the syndrome lasts up to 6 weeks).
• Chronic course of the disease.

According to the nature of the antigen.

Based on the name of edema, it is clear that it occurs without contact of the body with the antigen. Provoking factors for edema can be chemicals, psycho-emotional stress, and physical factors.

In this case, the occurrence of a reaction to the arrival of a specific allergen cannot be ruled out. The types of allergens will be described below.

Provoking factors may be:

1. anemia and other blood diseases;
2. liver damage;
3. painful stomach condition;
4. thyroid pathology;
5. autoimmune diseases such as lupus erythematosus;
6. parasitic worms.

• In this case, the disease often becomes lifelong and the person is forced to take medications throughout his life.
• In some cases, the etiology of Quincke's edema in adults and children has not been established.
• The stimulus for the manifestation of a negative reaction of the body is human contact with the allergen.

Various substances and agents can act as allergens:

1. medicines;
2. Food. It is known that allergies most often occur in response to the intake of citrus fruits, chocolate, especially milk chocolate, chocolates, nuts, and milk. Also the strongest allergens are dyes, preservatives and flavor enhancers;
3. pollen of higher plants;
4. undercoat, fluff and fur of domestic and wild animals;
5. toxins and poisons, especially insects;
6. microorganisms;
7. dust. Scientists have found that an allergic response does not occur to the dust itself, but to the microorganisms living in it.
8. cosmetics, or more precisely the components of cosmetic products. Often allergies occur to the use of mascara, creams, eye shadows;
9. household chemicals: washing powders, dishwashing detergents, floor cleaners, etc.;

An important role in helping with Quincke's edema and further treatment is played by recognition of the antigen that causes the body's response. It is necessary to observe in response to contact with which allergens the allergy begins. For this purpose, there are a number of tests to determine antigens.

Symptoms

The manifestations of Quincke's edema are the same for both adults and children. Common symptoms are:

• cough
• hoarseness of voice
• the skin takes on a bluish tint
• there is nasal discharge
• dermatitis
• possible conjunctivitis

Manifestations of the acute course of the disease will vary depending on the location of the lesion. In the acute form, swelling increases within 3-5 minutes; in the chronic course of the disease, the formation of edema can increase up to several days.

The chronic form of Quincke's edema does not form instantly, but over several hours. It may go away on its own, but it is better to call emergency services at the first sign of swelling.

The frequency of recurrence of swelling reaches up to 1 time in 2 days, provoking factors are varied: stress, temperature, allergens.

What to do with Quincke's edema depends on the location of the swelling.

On the face

If swelling begins to form on the face, then the swelling affects the cheeks, eyelids, nose, ears, lips. The patient experiences difficulty speaking, the lumen of the eyes narrows, visually they resemble eyes after a bee sting.

This type of swelling may go away on its own within a few hours or days, but assistance is necessary.

On the respiratory tract

If the swelling is localized in the upper respiratory tract, then the first symptom will be a dry cough, hoarseness in the voice, which was not previously characteristic, and the skin acquires a bluish tint due to a disruption in the supply of oxygen to the tissues. As the condition worsens, the skin becomes pale. A characteristic symptom is swelling of the neck, which gradually spreads to the face.

If assistance is not provided to such a patient, difficulty breathing may occur, leading to asphyxia and fainting. First aid for Quincke's edema in this condition should be urgent and follow a clear algorithm of actions.

On internal organs

1. When edema forms in the internal organs, the symptoms will resemble abdominal syndrome: weakness, nausea, vomiting, abdominal pain, loose stools, dry mouth.

2. Diagnosing this type of edema is quite difficult even for emergency doctors, so it is better to relieve Quincke’s edema in a hospital with proper examination.

3. When the first signs of incipient Quincke's edema are detected, it is necessary to follow a clear algorithm for assistance.

How to relieve angioedema at home

Help with angioedema in children must be provided as quickly as possible. Quincke's edema in children is dangerous because the child begins to cry, thereby impeding the supply of oxygen to tissues and organs and the risk of asphyxia increases sharply.

Pre-medical care for the patient will be aimed at maximizing the removal of swelling in adults and children. To do this you need:

1. Call an emergency medical ambulance, and indicate to the dispatcher all the symptoms of the disease.
2. If it is known which allergen caused such a reaction in the body, then it is necessary to protect the patient from further exposure to or exposure to the dangerous factor.
3. Quincke's edema is a severe emotional shock, especially for children and adults who have this condition for the first time. Therefore, providing assistance will be reduced to reducing the stressful background: it is better to sit the patient down, it is advisable to pick up a swollen child and calm him down.
4. If swelling is localized in the neck, larynx, or trachea, be sure to open the window for fresh air and free the neck from constricting clothing.
5. A cold compress will help relieve Quincke's edema. Frozen food from the refrigerator wrapped in a towel can be used as a cold compress to prevent hypothermia.
6. It is necessary to ensure that you receive a sufficient amount of warm water. If the development of the syndrome is associated with food intake (food allergy), you should drink absorbents (activated carbon, enterosgel, smecta). You must carefully read the instructions for use: the dosage for adults and children will be different.
7. If the swelling is located on the face, it is necessary to instill any vasoconstrictor into the patient.
8. For angioedema, first aid includes taking antiallergic drugs. It must be remembered that performing these measures is not a treatment, but only a relief from the symptoms of the disease.

It is worth noting that first aid for angioedema should be performed with caution. Drugs for Quincke's edema should be given with caution so as not to worsen the patient's condition.

Medical care for Quincke's edema

How to treat Quincke's edema will be decided by the attending physician, based on the causes and form of the edema. Medical care will also depend on the symptoms of the disease.

1. Drugs that suppress the activity of histamine in the body (Suprastin 2%, Parlazin, Cetrine, Zodac) are mandatory.
2. Hormonal therapy: glucocorticoids (Prednisolonum IM or IV; Dexason IV;)
3. Diuretics.
4. For hypotension, Sol is administered. Adrenalini hydrochloridi 0.1% i/m; in case of asphyxia, it is also necessary to administer Sol. Adrenalini hydrochloridi 0.1% i/m;
5. Polymerase inhibitor drugs: Contrykali 30,000 units in Sol. Natrii chloridi isotonicae 0.9%;
6. Therapy aimed at removing toxins from the body - hemosorption, enterosorption;
7. If bronchospasm develops, bronchodilator and anti-inflammatory drugs are given through a nebulizer.
8. In case of respiratory failure and cyanosis of the skin and mucous membranes, oxygen therapy is indicated.

• The required dosage of the drug should be calculated based on the instructions and recommendations of the doctor.
• Mortality from angioedema is not high, however, with severe disease and failure to provide emergency care, the chances of survival are reduced.
• Remember that preventing the occurrence of Quincke's edema is to limit contact with the allergen.

Source: https://topallergy.ru/zabolevaniya/otek-kwinke/pervaya-pomosh.html

What do they do in the emergency room? First aid for Quincke's edema

Quincke's edema (giant urticaria, angioedema) is an acute allergic disease in which extensive swelling of the mucous membranes and skin rapidly develops. Most often the face and neck, the upper part of the body swell, less often - the larynx, tongue and pharynx, meninges and internal organs. Read more about what Quincke's edema is in this article.

The triggers for this disease are:

• An allergic reaction - first there is contact with an allergen (drug, pollen, food product, insect venom, household dust), and then the body begins to fight it through increased production of immunoglobulins and the release of histamine into the blood. Histamine causes capillaries to dilate and increase their permeability, resulting in swelling.
• A non-allergic reaction is typical for children. In this case, histamine, which causes tissue swelling, is released when a toxic factor (for example, insect venom) directly affects specific cells.
• Hereditary predisposition – causes the appearance of hereditary angioedema. In this case, there is a genetic breakdown in the body, due to which the number of inhibitor proteins that suppress the action of complement (the body’s protective reaction by releasing histamine into the blood) is reduced. And with the most minor shocks to the body (they can even be stress or hypothermia), complement is activated and swelling appears.

The importance of providing timely first aid

Quincke's edema is a rather rare, but at the same time dangerous condition. In its severe forms, not only the skin and subcutaneous tissue of various parts of the face and body are affected, but also the internal organs and membranes of the brain. In such cases, pathological conditions similar to peritonitis and meningitis may occur.

But the most dangerous thing is swelling in the area of ​​the nasopharynx and larynx, in which narrowing airways can lead to oxygen starvation, suffocation, and in the most severe cases, death.

In children and preschool children, compared to adults, the likelihood of angioedema of the face and neck being aggravated by swelling of the respiratory tract increases significantly, so even if the child’s condition is satisfactory, it is necessary to seek competent medical help.

The characteristic symptoms of Quincke's edema are the rapidity and intensity of its development. Starting with a slight swelling, the edema in a matter of minutes can acquire life-threatening proportions, including asphyxia. Therefore, in such situations, every second counts and even before the ambulance specialists arrive, it is necessary to provide first emergency aid to the patient.

Emergency care for a patient with Quincke's edema

What to do to provide first aid to an adult with angioedema before the ambulance arrives at home:

• Help to take a comfortable position, ensuring the outflow of fluid from swollen parts of the body (if the legs are swollen, raise them; if the face and neck are swollen, sit the victim down).
• If possible, calm down and prevent panic.
• Provide access to oxygen: open the window, unbutton tight clothes.
• Stop the action of the allergen: remove the insect sting or remove it from the action of the chemical agent.
• If the cause of swelling is an insect bite or drug injection, apply a tourniquet above the affected area.
• Apply a cold compress to the swelling.
• To speed up the body’s ridding of the allergen, ensure plenty of drinking (preferably alkaline drink: Borjomi, Narzan, 1% baking soda solution), give sorbents (smecta, activated carbon, enterosgel).
• Give any antiallergic drug according to the age dosage: fenistil, fenkarol, suprastin, claritin, loratadine, cetirizine. Intramuscular administration of the drug is more effective, but if there is no qualified specialist nearby, taking 1-2 antihistamine tablets before the ambulance arrives is mandatory. Read more about modern antihistamines.
• Place any vasoconstrictor drops into the nose: Nazivin, Naphthyzin, Galazolin, Tizin.
• You can prepare hot foot baths (if your upper body is swollen).
• If bronchospasm develops, a nebulizer can be used to ease the patient's breathing.

When diagnosing angioedema, the ambulance team provides emergency care in the form of:

• intramuscular injection of prednisolone - to ease breathing
• subcutaneous injection of adrenaline
• intramuscular injection of suprastin - to neutralize the effect of histamine
• using diuretics (Lasix) to speed up the removal of the allergen from the body
• inhalation with salbutamol
• tracheotomy according to indications
• immediate hospitalization

Characteristic features of first aid for children with angioedema

Approximately 2% of children suffer from angioedema. As a rule, these are children with allergies, whose parents are aware of the high risk of the disease and have medications in their home medicine cabinet:

• antihistamine action: parlazin, fenkarol, fenistil
• adsorbents: activated carbon, polyphepan, enterosgel
• enzymatic preparations to reduce the sensitivity of the child’s body to food allergens: Creon, Panzinorm
• if there is a high risk of laryngeal edema, prednisolone for intramuscular injection

In children, the development of edema occurs more often and much faster than in adults. Therefore, the speed of reaction of parents in providing first aid and the immediate call of doctors is the key to the life and health of the child in this situation.

Algorithm for emergency care for angioedema

• Call an ambulance immediately
• Neutralize the effect of the allergen
• Help to find a comfortable position, provide a flow of fresh air, calm
• Give any antiallergic drug
• Place any vasoconstrictor drops into your nose
• Give frequent and abundant alkaline drinks
• Give activated carbon or any other adsorbent
• Apply a cold compress to the swollen area
• Monitor the patient's breathing and general condition

You may also be interested in:

• 
• 
• 

Source: http://idermatolog.net/principi-lechenia-kognih-bolezkii/otek-kvinke-pomosh.html

First aid for Quincke's edema: call an ambulance and act

People who suffer from allergies know that it is always unpleasant, but there are some forms of allergic reactions that can result in death. One of them is Quincke's edema. Doc.by has compiled an important reminder on how to provide first aid to a person who has had this unpleasant and deadly reaction.

What is Quincke's edema?

Quincke's edema occurs due to an excessive reaction of the immune system to any irritant (allergen). As a result, the body produces special substances responsible for inflammatory reactions - histamines and prostaglandins.

These substances affect the permeability of blood vessels (primarily small capillaries) and lymph from them begins to flow into the surrounding tissues. This is exactly how allergic Quincke's edema occurs. The name of this reaction was given in honor of the German physiologist Heinrich Quincke, who described similar edema in his patients at the beginning of the 19th century.

By the way, he also developed the first effective methods for treating such serious allergic reactions.

Quincke's edema is not very common, it is only 2% of the total number of allergic reactions. However, according to research, every 10th person has suffered from Quincke's edema at least once in his life, albeit in a mild form.

It is more common in children and young women, as well as people suffering from other allergic reactions. The causes can be absolutely any substance, food, pollen, volatile compounds, insect bites, etc.

Symptoms of Quincke's edema

The main symptoms of the reaction include:

• swelling and increase in size of the soft tissues of the face, head and neck;
• sometimes the swelling spreads to the arms (fingers), feet and upper chest;
• low pressure;
• tachycardia;
• increased sweating;
• confusion, loss of coordination;
• the appearance of anxiety, fear and anxiety;
• stomach upset;

The most frightening symptoms that can result in suffocation are: barking cough, sore throat, difficulty breathing, problems with speech.

First aid for Quincke's edema

If a person experiences the symptoms described above, you should immediately call an ambulance or take the patient to the hospital yourself. If this is not possible, you will have to provide emergency assistance yourself.

While the ambulance is on the way

First of all, the patient should be reassured. Bed rest is not required in this situation; it is better if the patient sits. If you know exactly the source of the allergy, you need to take all measures to ensure that it stops entering the body as soon as possible.

Stop eating, leave the place where allergens are in the air, etc. If the reaction is caused by an insect bite, remove its sting from the wound and apply a tourniquet above the bite site (this will stop the venom from spreading throughout the body). Remember that the tourniquet must be removed no later than 30 minutes after application.

If applying a tourniquet is not possible, apply ice or a cold compress to the bite site.

To make it easier for the victim to breathe, free him from tight clothing and open a window or door in the room.

If the allergen has entered the stomach, give the patient activated carbon in a dosage of 1 tablet per 10 kg of weight or other sorbents. It is impossible to induce vomiting, since with swelling of the larynx a person may choke on the vomit.

The main means of helping with Quincke's edema are antihistamines. It is better to choose first-generation drugs, since their speed of action is higher. To speed up absorption, you can not take the tablet orally, but put it under your tongue. In order to remove excess fluid from the body, it is recommended to take diuretics.

Injections of hormonal drugs are also used. They “turn off” the body’s immune responses to allergens. If it is impossible to give an injection, the contents of the ampoule should be poured under the tongue. Important: even if the patient’s condition has improved after taking medication, this is not a reason to cancel a visit to the hospital or call an ambulance.

A patient with Quincke's edema needs additional examination under the supervision of doctors.

Source: https://zen.yandex.ru/media/id/5a1fcdd879885e4727544362/5a8c4e6c9e29a2a3a8ed2239

Quincke's edema: symptoms and treatment

Quincke's edema is a sudden, acute redness and swelling of the mucous membranes, subcutaneous tissue, and skin. The causes of the phenomenon are different, most often it is an allergic reaction to an irritant. Adults over 20 years of age are at risk. In children, the phenomenon is dangerous due to rapid development, threatening respiratory arrest. Treatment of Quincke's edema should begin immediately. It is important to know how to provide first aid.

What is this

The body's reaction to chemical and physical irritants, often occurring due to allergies, manifested by swelling of the skin and mucous tissue under the skin. According to ICD-10, angioedema is located under code T.78.3.

Useful: List of cheap antibiotics for colds in adults

Causes

The cause of the disease is an immediate reaction of the body. At the physiological level, there is an increase in the sensitivity of basophils and mast cells.

The result of sensitization of blood cells is the rapid release of biologically active substances into the blood vessels: leukocytes, cytokines, histamine. Biologically active substances act on the walls of blood vessels, increasing their permeability.

When the integrity of the blood vessels is damaged, the liquid part of the plasma escapes into the tissue - this is a physiological cause of edema.

Allergens that cause a basophil reaction:

• Red, orange products containing food additives, flavor stabilizers, citrus fruits, chocolate;
• Cosmetics;
• Insect bite;
• Flower pollen, dust;
• Medicines.

The causes of angioneurotic reaction (AO) are sometimes physical factors: severe cold, unexpected injuries to the skin, bright light, chronic infection in the body. This is non-allergic swelling. Physiologically, it appears due to the synthesis of kinin-like peptide, a mediator responsible for the development of Quincke's edema. Immune mechanisms causing tissue damage are not involved.

Medicine knows of a hereditary disease that periodically results in Quincke's edema. The child inherits it if the allele that controls the production of C1-esterase inhibitors is heterozygous. Inherited in a dominant manner. With this disease, the IgE level remains within normal limits, antiallergic drugs do not help, and the patient does not complain of itching.

Symptoms

Pathology always manifests itself abruptly, complicates a person’s normal life activities, limits ability to work, and in the absence of important treatment, threatens life. Develops within a few minutes.

Main symptoms of the disease:

• acute swelling of the mucous membranes, skin, tissue under the skin;
• the face, back of the hands, and feet swell;
• high intensity of symptoms leads to cerebral edema;
• possible swelling of the bladder, uterus, joints;
• swollen skin is pale;
• absence or slight itching;
• Symptoms may last for several days and then disappear.

How to understand that the reason for the deterioration of the throat is the occurrence of this pathology?

Laryngeal edema is characterized by the appearance of bluishness of the face, hoarseness, and the inability to inhale and exhale normally. Swelling localized in the respiratory organs is dangerous; with this pathology there is a high risk of suffocation. With this form of the disease there is a high probability of complications. Shortness of breath, whistling during breathing, and a barking cough appear. Some patients died from suffocation.

Swelling of the mucous membranes of the gastrointestinal tract is characterized by symptoms: vomiting, diarrhea, sharp pain in the epigastric region.

It is not difficult for an experienced specialist to make a diagnosis visually: swelling of a particular part of the body, internal or external, is increasing.

Rare manifestations of the disease are swelling in the uterus and heart. With angioedema of the uterus, the organ increases to the size of a six-month pregnancy, fluid accumulates in the area of ​​the bladder and urogenital tract. When the pathology is localized in the heart area, the main symptom is paroxysmal tachycardia.

Useful: The best nootropic drugs

What does it look like

Below are photos of patients with Quincke's edema, which show what it is. The photo shows examples of the spread of hyperedema in different parts of the body in adults and children. Photos can be upsetting.

First aid

The person's condition is considered urgent. At the first sign of it, active work should be carried out to provide first aid from people who are nearby.

First aid algorithm:

1. Call an ambulance.

2. Urgently remove exposure to the allergen and contact with it.

3. Remove tight clothing.

4. Try to provide fresh air.

5. It is recommended to inject 3% Prednisolone solution under the skin, calculating 1-2 mg per 1 kg of patient weight.

6. Inject intramuscularly using antihistamines. A 2% solution of Suprastin, Pipolfen 2.5% is used.

7. In the form of tablets, put the drugs under the tongue: Suprastin, Cetrin, Claritin, etc.

8. Give plenty of fluids and sorbents to remove small allergen particles from the body. Activated carbon, White carbon, Enterozermina, Enterosgel, etc. are effective.

Treatment of pathology at home is dangerous and complications may arise. Emergency medical care can prevent death.

Urgent Care

When the doctors arrived, emergency assistance began. Algorithm for emergency actions for angioedema:

• An assessment of blood pressure and the risk of asphyxia is carried out. If the patient is in critical condition, a solution of Adrenaline (0.1%) with a maximum of 1 ml is administered intravenously.
• Intravenous injection of Prednisolone, Dexamethasone, Hydrocortisone - hormones for quick relief of an attack.
• Anti-allergy injections: Suprastin (2%), Diprazine (2.5%).
• Intravenous bolus of Lasix in saline solution 40-80 mg.
• Intravenous administration with saline solution (200 ml) Contrical 30,000 units.
• Removing toxins in the blood and from the gastrointestinal tract.
• If the condition worsens and asphyxia occurs, the emergency doctor performs a tracheostomy.

Providing care to the patient should continue in a hospital setting. The patient is hospitalized in different departments, depending on his condition: intensive care, intensive care, allergy.

Treatment

Treatment of angioedema begins with antihistamines aimed at eliminating the effect of the allergen. At this stage, the diagnosis is differentiated, the allergic or non-allergic cause of AO is determined. Groups of drugs are used in different dosages and combinations with other chemicals.

Drugs

When treating after hospitalization, an integrated approach is important - the use of medications aimed at supporting systems affected by immediate swelling. Many of them are administered by bolus or intravenously.

Antihistamines

Necessary for blocking histamine receptors, removes allergy symptoms. They have a sedative effect and indirectly inhibit the activity of the parasympathetic nervous system.

• Loratadine. Has antiallergic, antipruritic effects, helps relieve swelling. After 30 minutes it relieves allergy symptoms, the duration of action is 24 hours. The drug is taken for 10 to 15 days; it cannot be used in case of hepatitis B or hypersensitivity to the components.
• Chloropyramine is administered intravenously during the acute period on an outpatient basis. Old generation antihistamine. Adults 20-40 mg per day, children no more than 2 mg/kg per day.
• Tavegil. Blocks histamine H1 receptors, antiallergic, antipruritic drug. Helps reduce vascular permeability. Cannot be used for bronchial asthma, with simultaneous use of MAO inhibitors, children under 1 year of age, hypersensitivity to the drug. Intra-arterial administration is unacceptable.
• Suprastin - the active ingredient is chloropyramine hydrochloride. Has antiallergic, sedative, hypnotic effects, relieves itching. The drug helps maintain the strength of blood vessels and has a beneficial effect on the central nervous system. Injections for angioneurotic reactions are administered intravenously, then a transition to intramuscular injections occurs. The medicine is contraindicated in acute asthma, closed glaucoma, stomach ulcers, myocardial infarction, urinary retention, and prostate pathology.

Corticosteroids

Hormones that have an anti-inflammatory effect. They allow you to control the immune system, metabolic processes in the body, and restore tissue structure. During hospitalization, systemic glucocorticosteroids are used.

• Celeston – used as an anti-inflammatory, antiallergic, antipruritic agent. Suppresses the functions of leukocytes and tissue macrophages. Prevents the direction of a large number of leukocytes to the area of ​​edema. It has a large number of side effects, the dose and course of treatment is agreed with the doctor.
• Prednisolone is an analogue of Hydrocortisone. Action: anti-inflammatory, anti-allergic, anti-shock, desensitizing, immunosuppressive - inhibits the activity of T- and B-lymphocytes.
• Dexamethasone - has a strong antiallergic, antiallergic effect. The acute period requires an increased dose of the drug, then the dosage is reduced to a maintenance dose or cessation of treatment.
• Flucinar is a synthetic glucocorticosteroid. It is applied externally and is well absorbed through the skin. It is used for external manifestations of angioedema.
• Nasonex is a drug for use in the nasal cavity. Used for swelling in the nasopharynx. Has anti-inflammatory, anti-allergic effect.

Diuretics

Helps remove fluid from the body. A group of drugs removes beneficial sodium and potassium ions along with the liquid. Long-term treatment is not allowed

• Furosemide is a fast-acting diuretic, the effect is strong and short-term. The onset of the effect is observed 10-15 minutes after intravenous administration of the drug.
• Indapamide is a diuretic, antihypertensive agent. They work for a long time.
• Triamterene – has a diuretic effect, prevents the excretion of increased amounts of sodium ions. The effect appears 15-20 minutes after administration. The action lasts for 12 hours. Cannot be used for pathologies of the kidneys or liver.

Enterosorbents

The drugs are necessary to remove toxins and allergens from the body. They are removed from the intestines by binding to toxic substances. Cleanses the blood, liver and gastrointestinal tract. A cleansing enema and gastric lavage are also used to remove remnants of the allergen from the digestive organs.

• Atoxil is a 4th generation enterosorbent. Action: pronounced sorption, wound healing, antiallergic, antimicrobial, detoxification. Helps remove food and bacterial allergens, toxic substances formed during the decay of proteins in the intestines. Removes toxins from the blood, lymph, and body tissues.
• Activated carbon has an antidiarrheal, detoxifying and enterosorbing effect. Removes toxins, poisons, and allergen particles from the body before they are absorbed into the gastrointestinal tract. Use 1 tablet per 10 kg of patient weight for 5 to 10 days. The drug weakly removes alkalis and acids.
• Multisorb - made in powder form. Promotes the removal of harmful substances from the body, leads to increased intestinal motility, has a strong sorbing effect, acts as a detoxicant for allergic reactions, Quincke's edema.

Cell membrane stabilizers

They are used to stabilize the allergic process, reducing the hypersensitivity of the area affected by swelling.

• Ketotifen - used for instillation into the conjunctival sac, orally in powder form. Used by elderly people, adults, children over 8 years old.

Enzymes

Necessary to reduce sensitivity to food allergens. Drugs in this group are prescribed by a doctor based on the patient’s condition.

• Pancreatin - helps to improve digestive function, disturbed by the body’s allergic reaction, and helps eliminate remnants of allergens. For an adult, the maximum daily dose is 16,000 IU of lipase - that's 4 tablets per meal. Contraindicated in children under 2 years of age, pregnant and lactating women.
• Creon - the active substance of the drug - pancreatin. Approximately 25,000 units of lipase are taken with each meal. Contraindicated in pancreatitis.
• Festal - consists of several enzymes: lipase, protease, amylase. Take 1-2 tablets with meals 3 times a day. Cannot be used for hepatitis, obstructive jaundice (blockage of the biliary tract).

Antifungal drugs

They are used only when sowing fungal flora during swelling; without exact certainty that the patient has fungal foci, special preparations cannot be used.

• Fluconazole – used up to 400 mg once a day. The dose is prescribed by the doctor taking into account the individual manifestations of the pathology.
• Nystatin - up to 100,000 units 4 times a day. Used after meals. The course of treatment is 7 days.

Additional measures

According to the protocol for the treatment of angioedema (M3 RK - 2016), on an outpatient basis, the patient must be given an alkaline drink to remove allergens and improve microcirculation. It is important to follow a hypoallergenic diet: exclude all foods that create the likelihood of pathology. Perform an antigen sparing regimen for the patient.

If severe swelling is localized in the nasopharynx, a tracheostomy is performed - this is an incision in the trachea to facilitate breathing for the patient. The next stage of swelling is anaphylactic shock.

In this condition, a person experiences itching, difficulty breathing, loss of consciousness and convulsions. Such symptoms are indications for transferring the patient to the intensive care unit.

Source: https://plannt.ru/otek-kvinke-simptomy-i-lechenie