Cellular immunity
Specialized WBCs, T cells, that attack and destroy invaders.
Humoral immunity
B cell lymphocytes produce antibodies that dissolve in plasma and lymph to wage war on invading organisms.
Action and location of IgA
Action : localized protection to mucous membranes. Levels can be lowered by stress.
Location : tears, saliva, breast milk, GI secretions, blood, and lymph.
Action and location of IgD
Action : stimulates antibody-producing cells to make antibodies
Location : blood, lymph, and surface of B cells
Action and location of IgE
Action: responds in allergic reaction
Location : mast and basophil cells
Action and location of IgG
Action : protection against bacteria and viruses; enhances phagocytosis; neutralizes toxins triggers the complement system
Location : blood, lymph, intestines
Action and location of IgM
Action : fir antibody to appear; causes agglutination and lysis of microbes.
Location : blood, lymph, and surface of B cells
Chemical mediators
Histamine
Leukotrienes
Platelet-activating factor
Serotonin
Physiologic effects of histamine
Systemic vasodilation Increased permeability of blood vessels Decreased cardiac contractility Decreased coronary blood flow Dysrhythmias Bronchoconstriction Pulmonary vasoconstriction
Physiologic effects of leukotrienes
Vascular permeability Bronchoconstriction Decreased force of cardiac contraction Decreased coronary blood flow Dysrhythmias
Physiologic effects of platelet-activating factor
Platelet aggregation
Causes histamine release
Physiologic effect of serotonin
Pulmonary vasoconstriction
Bronchoconstriction
What should you evaluate when performing a skin exam?
Erythema Rashes Edema Moisture Pruritus Urticaria Pallor cyanosis Bite/sting marks
When should you consider second dose of epinephrine?
No improvement after 5 minutes
Decreased mental status
Increased breathing difficulty
Decreased BP
Management of anaphylaxis
Remove offending agent Position patient as appropriate Apply high-flow oxygen or assist with ventilations Obtain IV access Give fluid resuscitation as needed Administer epi and antihistamine as indicated Transport promptly Frequently reassess Psychologic support
Late sign of an allergic reaction.
Cyanotic, cool skin
Hypotension
s/s of insect stings and bites
Sudden pain, swelling, localized heat
Widespread urticaria
Redness
Itching, wheal
Management of insect stings
Remove stinger Position injection site below level of the heart. Apply ice or cold packs to the area NPO Supine if indicated and oxygen PRN
Patient education on anaphylaxis and allergic reactions should include:
Avoid the antigen
Notify all health personnel of the allergy
Wear ID tags or bracelets
Report sxs early
