Abstract
In clinical field, one of the most considerable points is how to care for the shock. Especially in the case of allergic patients, various adverse reactions including anaphylaxy shock are the big problem. We presented several cases of shock in our department of allergy and described our method of countermeasure.
A. Various shock
Case 1: Intradermal skin test shock. Case 2: Hyposensitization therapy shock. Case 3: Hydrocortisone shock. Case 4: ACTH shock. (rapid ACTH test) Case 5: Antibiotics shock (CER). Case 6: lode and Ketamine HCl shock. Case 7: Withdrawal syndrome in the step of reducing steroid.
B. Our countermeasure
Case 1: Prick (Scratch) test should be done before intradermal test. Case 2: Fasten patient's arm at the upper area of injection as soon as possible, then give epinephrine both upper and lower side. Case 3: Inject slowly, and observe clinical findings carefully. Case 4: Skin test should be done before rapid ACTH test. One hour drip infusion method is recommended. Case 5, 6: Skin test and history taking were important. Case 7: During reduction of steroid, careful observation must be done and also checking 17-OHCS, 17-KS and 17-KGS in urine was recommended.
In this study, we emphasiszed following two points. First, if patient condition is allergic, skin test is useful to prevent adverse reactions. Second, physicians should prepare the emergency kit near the bed.
