what to do before the ambulance?
Important: those who know they are allergic to the stings of wasps or other similar insects (such as bees, hornets, called hymenoptera) must always have an adrenaline “pen” on them.
It is an auto-injector that allows a quick, efficient and safe injection of the right dose of adrenaline.
Adrenaline can indeed save lives in such cases, but only if given in the right amount (1 mg taken per 10 ml with saline solution).
In case of anaphylactic shock by wasp sting, or even simply suspicion of anaphylactic shock:
What to do:
- Alert medical help immediately without wasting time, perhaps by searching the Internet for information!
- Although the actual therapy is the sole responsibility of the physician, it is good for the rescuer to know the basics of what to do. The life-saving drug during an anaphylactic shock is adrenaline (or epinephrine) administered intravenously, preferably by slow and continuous infusion. It is combined with electrolytes or colloidal infusion solutions to compensate for peripheral vasodilation, hypotension and leakage of intravascular fluids into the tissues. Additional medications may be required depending on the functional impairment of the affected organs.
- While in the mildest cases the combined administration of adrenaline and antihistamines (which, like corticosteroids, inhibit the activity of vasoactive mediators involved in shock) is usually sufficient, in the most severe cases, it is necessary to maintain the patency of the airways, using oxygen therapy or surgery if necessary.
- When anaphylactic shock is suspected, pending medical treatment, the patient should be placed in an anti-shock position → supine position with the legs raised approximately 30 cm (e.g. using ‘a chair). If possible, the patient should be positioned so that the head is below the knees and pelvis. This position, called Trendelenburg, is particularly useful because it promotes venous return to the vital organs (heart and brain) by the simple effect of gravity.
While waiting for medical help, the person suffering from anaphylactic shock should be reassured and, if possible, comforted about their condition and the arrival of the ambulance.
What NOT to do if you suspect anaphylactic shock
If anaphylactic shock is caused by a bee sting, the stinger should not be extracted with tweezers or fingers, as compressing it will increase the release of venom; rather, it is advisable to scrape it off with a fingernail or a credit card.
However, recent studies have shown that what really matters is the speed of the intervention; the longer the time between the puncture and the extraction of the venom, the greater the release of the venom; according to these studies, it is therefore not so much the extraction technique that is important, but rather the speed of the intervention.
The anti-shock position should not be adopted if trauma to the head, neck, back or legs is suspected.
If the victim complains of difficulty breathing, do not place elevations or pillows under the head, or administer pills, liquids, or food; these operations, in fact, risk seriously aggravating the obstruction of the passage of air in the airways which typically accompanies episodes of anaphylactic shock.
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