EMERGENCY MANAGEMENT AND PHARMACOLOGICAL PROTOCOLS IN THE TREATMENT OF ANAPHYLACTIC SHOCK

Abstract

Introduction: Anaphylaxis is a serious and potentially fatal medical emergency characterized by rapid compromise of the airway, breathing, and/or circulation. This study aimed to review and synthesize recent scientific evidence on emergency management and pharmacological protocols in the treatment of anaphylactic shock. Methods: A narrative literature review was conducted in the PubMed and JACI: In Practice databases, using the descriptors "Anaphylaxis" and "Therapeutics," focusing on articles published in the last five years. Results: Intramuscular (IM) adrenaline in the anterolateral aspect of the thigh is confirmed as the absolute mainstay of first-line treatment, and its immediate administration is indispensable upon clinical suspicion. Antihistamines and corticosteroids have a secondary role, restricted to the management of cutaneous symptoms (urticaria/angioedema), and should under no circumstances delay the administration of adrenaline. For cases of refractory anaphylaxis (persistence of symptoms after two IM doses of adrenaline), protocols require advanced support, including continuous intravenous infusion of adrenaline, aggressive volume replacement with crystalloids, and, specifically for patients using beta-blockers, the administration of glucagon. The literature highlights that diagnostic hesitancy and fear of underutilizing adrenaline are critical factors contributing to severe outcomes. Conclusion: Early identification of anaphylaxis, overcoming therapeutic hesitancy, and immediate administration of adrenaline are crucial to optimize patient survival, emphasizing the need for continuous standardization of care protocols.