Summary
Definition
History and exam
Key diagnostic factors
- 急性发作
- 气道肿胀(血管性水肿)
- 吸气相鸣音和声音嘶哑
- 呼吸短促
- 喘息、胸部过度充气和辅助呼吸肌参与呼吸
- 紫绀
- 呼吸骤停
- 面色苍白、皮肤湿冷
- 低血压
- 脉率增加(心动过速)
- 心动过缓
- 心搏骤停
- 意识模糊或定向障碍
- 荨麻疹(风团)
- 红斑
- 瘙痒
- 血管性水肿
- 鼻炎
- 双侧结膜炎
Other diagnostic factors
- 危险因素
- 恶心、呕吐、腹泻和失禁
- 腹部绞痛和疼痛
- 激越、焦虑和感到在劫难逃(死亡恐怖)
Risk factors
- 成年:食物、昆虫毒素及药物相关
- 30 岁以下人群:食物相关运动诱发
- 女性
- 特应性疾病/哮喘
- 全身过敏反应既往史
- 接触常见致敏物(例如乳胶)
Diagnostic tests
1st tests to order
- 肥大细胞类胰蛋白酶
- 12 导联心电图
- 尿素和电解质
- 动脉血气分析
Tests to consider
- 胸部 X 线检查
Treatment algorithm
疑诊全身过敏反应:心跳呼吸骤停
疑诊全身过敏反应:未出现心跳呼吸骤停
初始治疗后:未出现心跳呼吸骤停
全身过敏反应后
Contributors
Expert advisers
Alexander Alexiou, MB BS BSc DCH FRCEM Dip IMC RCSEd
Emergency Medicine Consultant
Barts Health NHS Trust
Physician Response Unit Consultant
London’s Air Ambulance
Royal London Hospital
London
UK
Disclosures
AA declares that he has no competing interests.
Thomas Palmer, BSc MBChB FRCEM
ST6 Emergency Medicine
Royal London Hospital
London
UK
Disclosures
TP declares that he has no competing interests.
Acknowledgements
BMJ Best Practice would like to gratefully acknowledge the previous team of expert contributors, whose work has been retained in parts of the content:
Doerthe Adriana Andreae MD
Assistant Professor
Pediatric Allergy and Immunology
Penn State Health Milton S. Hershey Medical Center
Hershey
PA
Michael Henning Andreae MD
Associate Professor
Department of Anesthesiology
Penn State Health Milton S. Hershey Medical Center
Hershey
PA
Disclosures
DAA is author of an UpToDate article on food allergy and a number of references cited in this topic. MHA is an author of a reference cited in this topic.
Peer reviewers
Robert Taylor, MBChB MRCP(UK) MRCP(London) DipMedTox DipTher PGDME FHEA FRCEM
Acute Hospital Sub Dean (Cornwall)
Honorary Clinical Senior Lecturer
Consultant Emergency Physician
The Knowledge Spa
Royal Cornwall Hospital
Truro
UK
Disclosures
RT declares that he has no competing interests.
Editors
Celia Pincus
Section Editor, BMJ Best Practice
Disclosures
CP declares that she has no competing interests.
Susan Mayor
Lead Section Editor, BMJ Best Practice
Disclosures
SM works as a freelance medical journalist and editor, video editorial director and presenter, and communications trainer. In this capacity, she has been paid, and continues to be paid, by a wide range of organisations for providing these skills on a professional basis. These include: NHS organisations, including the National Institute for Health and Care Excellence, NHS Choices, NHS Kidney Care, and others; publishers and medical education companies, including the BMJ Group, the Lancet group, Medscape, and others; professional organisations, including the British Thoracic Oncology Group, the European Society for Medical Oncology, the National Confidential Enquiry into Patient Outcome and Death, and others; charities and patients’ organisations, including the Roy Castle Lung Cancer Foundation and others; pharmaceutical companies, including Bayer, Boehringer Ingelheim, Novartis, and others; and communications agencies, including Publicis, Red Healthcare and others. She has no stock options or shares in any pharmaceutical or healthcare companies; however, she invests in a personal pension, which may invest in these types of companies. She is managing director of Susan Mayor Limited, the company name under which she provides medical writing and communications services.
Rachel Wheeler
Lead Section Editor, BMJ Best Practice
Disclosures
RW declares that she has no competing interests.
Julie Costello
Comorbidities Editor, BMJ Best Practice
Disclosures
JC declares that she has no competing interests.
Adam Mitchell
Drug Editor, BMJ Best Practice
Disclosures
AM declares that he has no competing interests.
Differentials
- 脓毒性休克
- 心源性休克
- 低血容量休克
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- 严重过敏反应的急诊处理
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