Anaphylaxis is a life-threatening systemic hypersensitivity reaction that can rapidly progress to anaphylactic shock, airway compromise, and cardiovascular collapse. Early recognition and treatment are essential to prevent mortality.
In this episode, we provide a comprehensive review of anaphylaxis, beginning with epidemiology and underlying immunologic mechanisms including IgE-mediated mast cell and basophil activation. We review the pathophysiology of mediator release, vascular permeability, vasodilation, and bronchospasm that drive the clinical syndrome.
We then cover classic and atypical symptoms, diagnostic considerations, and bedside evaluation strategies in emergency and critical care settings. Management is presented step-by-step, emphasizing early intramuscular epinephrine, airway protection, fluid resuscitation, adjunctive therapies, and monitoring.
The second half of the episode focuses on a deep dive into anaphylactic shock, including hemodynamic profiles, refractory shock physiology, vasopressor selection, and escalation strategies for patients with persistent hypotension despite epinephrine.
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Playlist on Shock: https://youtube.com/playlist?list=PLf5bMa9_tvRjunk4I-rQZYPZn3qHqWFqW&si=kserFPPm7RYuhul-
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