anaphylactic shock from yellowjackets

[sahai1]

Interesting the reaction of the man above that fainted at the gas station.Thats a real allergic.He got a panic atack because his body released the adrenaline wich made.him breathe too fast until he fainted because he got too much oxigen in his blood.Basically the body realised his reaction is overrated and it had a mechanism to stop it by itself.

I like your bee pollen story, I will go buy some.. how do you know if good quality? 

But for the man at the gas station... I think you are wrong and right.  For example one part of Anaphylaxis is is tachycardia which can cause hypotension.  High BPM/HR heart rate, leading to low blood pressure, which causes dizziness and fainting.  So he may or may not have panicked, but maybe have high cholesterol and a high BPM regularly.

[SeaWalnut]

Difficulty of breathing means that the body allready released the adrenaline and breathing fast from it could cause a person to faint and stop breathing for a few minutes until the oxigen level lowers in the blood ( just like from a panic atack).
Unfortunately,people that die from allergy to stings dont release the adrenaline into their body,they dont breathe faster,are not skared and usually die in 5 minutes after the sting.Those are rare cases and even if one such alergic would have a epy pen with it ,i dont think would make it in most cases.Would not have time or be conscious to use it.
So prevention its the best thing you can do.Go at a hospital and check if your allergic to stings( its cheap) and eat bee pollen after that ,talk with your medic.

Edit:good bee pollen its raw from beekeepers.Ask them if its raw.The one from supermarkets its most probably cooked and probably less active.
You dont have to eat much because most of it cant be digested by humans so its not really a nutritional food but something that keeps you fit.
Always tell the doctor you ate pollen if you get blood tests because it will mess with the tests.

[palmcity]

But for the man at the gas station... I think you are wrong and right.  For example one part of Anaphylaxis is is tachycardia which can cause hypotension.  High BPM/HR heart rate, leading to low blood pressure, which causes dizziness and fainting.  So he may or may not have panicked, but maybe have high cholesterol and a high BPM regularly.

In anaphylactic shock tachycardia does not cause the hypotension. It is caused by vasodilation by histamine and loss of fluid from the circulatory system into the surrounding tissues causing reduced volume of blood for the heart to pump. The tachycardia is the body's attempt to raise blood pressure back to normal levels. Blood pressure = Cardiac Output x Vascular resistance.

I am concerned with the number of gardeners reading these posts titled "anaphylactic shock from yellowjackets".  The main point is anaphylactic reactions can be deadly as well as repeat exposure to the antigen at a later time. Prevention if possible and taking appropriate drug therapy & getting medical help if exposed again or suspected anaphylactic episode can be a life saving event. Many gardeners will read the later comments of general allergic reactions and think they can wait on going to a hospital or using their epinephrine injection during a true anaphylactic shock reaction to an antigen.

A different post should have been created if desiring to talk about non life threatening events as anaphylactic shock is a life threatening event.

To make it easy, Here is a good video on anaphyylactic shock from Association of American Medical Colleges and Khan Academy ::: or read the transcript and read peoples comments below the video... https://www.khanacademy.org/science/health-and-medicine/circulatory-system-diseases/shock/v/anaphylactic-shock
Anaphylactic Shock is probably one of the shocks that most people are familiar with. It's also known as anaphylaxis. Anaphylactic shock is an allergic reaction that's severe enough to cause shock. And of course shock is decreased tissue perfusion, or in other words decreased oxygenation of tissues. There are a number of different things that can cause an allergic reaction. For example, bee stings can cause an allergic reaction, peanut allergies, food allergies, pollen can cause allergic reactions and so can certain medications as well. Now of course, allergies can be either very mild and seasonal such as hay fever and sometimes allergies can be so severe that it can cause shock. But how does it cause shock? Well first of all to answer that, I want to acknowledge that there are two types of anaphylaxis. Those that are immunologic and those that are non-immunologic. And I'll go ahead and start with immunologic anaphylaxis, because that's actually the most common type. In immunologic anaphylaxis, there's some sort of allergic agent, whether it's poison from a bee sting or a food allergy that somehow gets in to the system. And whatever this material is, it's known as an allergen because it generates an allergic response. So when this allergen first gets into the body, it will interact with B cells, and not B cells like the insect, the bee right up here, but B cells as in the letter B. Now these cells are the antibody creating cells of the immune system, they create antibodies. And antibodies are essentially a little Y shaped protein that is used like a signal marker to find something that's foreign, foreign material. So in this case, the antibodies will be reacting to the allergen. Now antibodies that are created in response to an allergen, are known as IgE. IgE stands for immunoglobulin E. Globulin means protein and immuno just means immune. So really it's immune protein and the classification is E. Now the reason I want to emphasis this, is because IgE specifically docks on to other immune cells which are known as Mast Cells, and these mast cells are mediators of the immune system. So what ends up happening is, once IgE is created, it will dock on to these mast cells. So this all occurs when a person is first exposed to an allergen, and this is called sensitization. The immune system is sensitized to this allergen. So the next time that this allergen comes along, it will create a rapid, allergic response. The allergen will dock on to these antibodies and when they do, the mast cells activate. And when mast cells activate, two main things happen. First of all, mast cells release immune molecules known as cytokines. Cytokines are essentially used for cellular communication. So mast cells communicate with other white blood cells and tell them to come over. So what ends up happening is these white blood cells continue to recruit more white blood cells, and it's a cycle that creates more and more white blood cells being recruited and activated in response to these allergens. Now that activation of both the mast cells and the immune cells, causes release of another molecule known as histamine. Now histamine is a potent vasodilator. In other words, it dilates blood vessels. So here, with the dotted line, I'm showing a blood vessel size before and after histamine, the diameter of the blood vessel increases. Now this is happening in the blood stream in the entire body, and it causes a large drop in blood pressure. So patients lose the function of their circulatory system and are no longer able to distribute oxygen and so that's how an allergy causes shock. And also, let me note that histamine causes blood vessels to become leaky, so fluid escapes the vascular space which causes swelling to occur all throughout the body. So a patient has massive swelling along with a massive drop of blood pressure. Now the second type of anaphylaxis is called non-immunologic. Now non-immunologic anaphylactic shock is essentially the same as immunologic shock, it's just the pathology is slightly different. Instead of mast cells being stimulated by IgE, the allergen specifically targets the receptors on the mast cells. And so you get the same process of histamine release as well as cytokine release, which of course causes the super immunological response as more white blood cells are recruited and then also causes this drop of blood pressure. So what are the symptoms that we see in anaphylactic shock? Well the symptoms are going to be characterized by the actions of histamine. So a patient with anaphylactic shock has this major drop in blood pressure due to vessel dilation. So we'll see flushing of the skin, as blood vessels dilate and blood starts to saturate in the skin. And swelling as fluid is getting outside of the blood vessels. And itchiness, which is also caused by histamine release. So these are all symptoms that you would come to expect from an immune response. You may see other various symptoms such as rhinorrhea, which is a runny nose and this is caused by vessel dilation in the nasal vasculature, so you have an overactive release of fluid. But the symptom that I really want to get to, occurs with the lungs. Histamine not only causes vessel dilation, one of it's most serious symptoms is bronchospasms. Spasms of the bronchi, the main air passages to the right and left lungs. So these bronchospasms make it difficult for a patient to breath. What makes it worse also is that swelling can be occuring in the throat as well, which can close off the airway, making it even more difficult to breath. So a patient comes in whose non-responsive, he's not breathing, and you check and find that the patient has a very low blood pressure. So what do you do? Do you order lab tests? No, that's a terrible idea. This patient is having a severe bout of shock. It should already be apparent based off of the clinical symptoms that this patient has. Especially the low blood pressure, severe low blood pressure should indicate that right away, something needs to be done. So you progress right to treatment. And treatment is based off of the ABC's, airway, breathing and circulation. So number one, you want to establish the airway. If a patient is not breathing, you want to give them 100% oxygen so you can fill up their lungs. And ventilating the patient with a bag mask, to push air into the lungs, may be one of the first ways to respond to a patient who has anaphylactic shock. Along with this, the blood pressure needs to be maintained. And there's one medication that's especially effective at maintaining blood pressure in patient's with anaphylactic shock and that's epinephrine. First of all, of course patients have these very dilated blood vessels. Now epinephrine has strong sympathetic activity, so it acts in a way to constrict blood vessels back down to maintain blood pressure. So this directly counteracts what histamine does to blood vessels. Epinephrine also effects the lungs and causes bronchodilation, so it opens up the airways. So this is important to allow airflow back into the lungs. Now to also maintain blood pressure, IV fluids will help fill up the vascular space. So these are the main ways to treat a patient with anaphylaxis. And along with this, you can give antihistamines to really directly counteract the effects of histamine in the body. But of course, let me emphasize that epinephrine and IV fluids are the mainstay of treatment, because they act to immediately reverse the low blood pressure and restore a patient's circulatory system.
https://www.khanacademy.org/science/health-and-medicine/circulatory-system-diseases/shock/v/anaphylactic-shock

[Jungle Yard]

But for the man at the gas station... I think you are wrong and right.  For example one part of Anaphylaxis is is tachycardia which can cause hypotension.  High BPM/HR heart rate, leading to low blood pressure, which causes dizziness and fainting.  So he may or may not have panicked, but maybe have high cholesterol and a high BPM regularly.

In anaphylactic shock tachycardia does not cause the hypotension. It is caused by vasodilation by histamine and loss of fluid from the circulatory system into the surrounding tissues causing reduced volume of blood for the heart to pump. The tachycardia is the body's attempt to raise blood pressure back to normal levels. Blood pressure = Cardiac Output x Vascular resistance.

I am concerned with the number of gardeners reading these posts titled "anaphylactic shock from yellowjackets".  The main point is anaphylactic reactions can be deadly as well as repeat exposure to the antigen at a later time. Prevention if possible and taking appropriate drug therapy & getting medical help if exposed again or suspected anaphylactic episode can be a life saving event. Many gardeners will read the later comments of general allergic reactions and think they can wait on going to a hospital or using their epinephrine injection during a true anaphylactic shock reaction to an antigen.

A different post should have been created if desiring to talk about non life threatening events as anaphylactic shock is a life threatening event.

To make it easy, Here is a good video on anaphyylactic shock from Association of American Medical Colleges and Khan Academy ::: or read the transcript and read peoples comments below the video... https://www.khanacademy.org/science/health-and-medicine/circulatory-system-diseases/shock/v/anaphylactic-shock
Anaphylactic Shock is probably one of the shocks that most people are familiar with. It's also known as anaphylaxis. Anaphylactic shock is an allergic reaction that's severe enough to cause shock. And of course shock is decreased tissue perfusion, or in other words decreased oxygenation of tissues. There are a number of different things that can cause an allergic reaction. For example, bee stings can cause an allergic reaction, peanut allergies, food allergies, pollen can cause allergic reactions and so can certain medications as well. Now of course, allergies can be either very mild and seasonal such as hay fever and sometimes allergies can be so severe that it can cause shock. But how does it cause shock? Well first of all to answer that, I want to acknowledge that there are two types of anaphylaxis. Those that are immunologic and those that are non-immunologic. And I'll go ahead and start with immunologic anaphylaxis, because that's actually the most common type. In immunologic anaphylaxis, there's some sort of allergic agent, whether it's poison from a bee sting or a food allergy that somehow gets in to the system. And whatever this material is, it's known as an allergen because it generates an allergic response. So when this allergen first gets into the body, it will interact with B cells, and not B cells like the insect, the bee right up here, but B cells as in the letter B. Now these cells are the antibody creating cells of the immune system, they create antibodies. And antibodies are essentially a little Y shaped protein that is used like a signal marker to find something that's foreign, foreign material. So in this case, the antibodies will be reacting to the allergen. Now antibodies that are created in response to an allergen, are known as IgE. IgE stands for immunoglobulin E. Globulin means protein and immuno just means immune. So really it's immune protein and the classification is E. Now the reason I want to emphasis this, is because IgE specifically docks on to other immune cells which are known as Mast Cells, and these mast cells are mediators of the immune system. So what ends up happening is, once IgE is created, it will dock on to these mast cells. So this all occurs when a person is first exposed to an allergen, and this is called sensitization. The immune system is sensitized to this allergen. So the next time that this allergen comes along, it will create a rapid, allergic response. The allergen will dock on to these antibodies and when they do, the mast cells activate. And when mast cells activate, two main things happen. First of all, mast cells release immune molecules known as cytokines. Cytokines are essentially used for cellular communication. So mast cells communicate with other white blood cells and tell them to come over. So what ends up happening is these white blood cells continue to recruit more white blood cells, and it's a cycle that creates more and more white blood cells being recruited and activated in response to these allergens. Now that activation of both the mast cells and the immune cells, causes release of another molecule known as histamine. Now histamine is a potent vasodilator. In other words, it dilates blood vessels. So here, with the dotted line, I'm showing a blood vessel size before and after histamine, the diameter of the blood vessel increases. Now this is happening in the blood stream in the entire body, and it causes a large drop in blood pressure. So patients lose the function of their circulatory system and are no longer able to distribute oxygen and so that's how an allergy causes shock. And also, let me note that histamine causes blood vessels to become leaky, so fluid escapes the vascular space which causes swelling to occur all throughout the body. So a patient has massive swelling along with a massive drop of blood pressure. Now the second type of anaphylaxis is called non-immunologic. Now non-immunologic anaphylactic shock is essentially the same as immunologic shock, it's just the pathology is slightly different. Instead of mast cells being stimulated by IgE, the allergen specifically targets the receptors on the mast cells. And so you get the same process of histamine release as well as cytokine release, which of course causes the super immunological response as more white blood cells are recruited and then also causes this drop of blood pressure. So what are the symptoms that we see in anaphylactic shock? Well the symptoms are going to be characterized by the actions of histamine. So a patient with anaphylactic shock has this major drop in blood pressure due to vessel dilation. So we'll see flushing of the skin, as blood vessels dilate and blood starts to saturate in the skin. And swelling as fluid is getting outside of the blood vessels. And itchiness, which is also caused by histamine release. So these are all symptoms that you would come to expect from an immune response. You may see other various symptoms such as rhinorrhea, which is a runny nose and this is caused by vessel dilation in the nasal vasculature, so you have an overactive release of fluid. But the symptom that I really want to get to, occurs with the lungs. Histamine not only causes vessel dilation, one of it's most serious symptoms is bronchospasms. Spasms of the bronchi, the main air passages to the right and left lungs. So these bronchospasms make it difficult for a patient to breath. What makes it worse also is that swelling can be occuring in the throat as well, which can close off the airway, making it even more difficult to breath. So a patient comes in whose non-responsive, he's not breathing, and you check and find that the patient has a very low blood pressure. So what do you do? Do you order lab tests? No, that's a terrible idea. This patient is having a severe bout of shock. It should already be apparent based off of the clinical symptoms that this patient has. Especially the low blood pressure, severe low blood pressure should indicate that right away, something needs to be done. So you progress right to treatment. And treatment is based off of the ABC's, airway, breathing and circulation. So number one, you want to establish the airway. If a patient is not breathing, you want to give them 100% oxygen so you can fill up their lungs. And ventilating the patient with a bag mask, to push air into the lungs, may be one of the first ways to respond to a patient who has anaphylactic shock. Along with this, the blood pressure needs to be maintained. And there's one medication that's especially effective at maintaining blood pressure in patient's with anaphylactic shock and that's epinephrine. First of all, of course patients have these very dilated blood vessels. Now epinephrine has strong sympathetic activity, so it acts in a way to constrict blood vessels back down to maintain blood pressure. So this directly counteracts what histamine does to blood vessels. Epinephrine also effects the lungs and causes bronchodilation, so it opens up the airways. So this is important to allow airflow back into the lungs. Now to also maintain blood pressure, IV fluids will help fill up the vascular space. So these are the main ways to treat a patient with anaphylaxis. And along with this, you can give antihistamines to really directly counteract the effects of histamine in the body. But of course, let me emphasize that epinephrine and IV fluids are the mainstay of treatment, because they act to immediately reverse the low blood pressure and restore a patient's circulatory system.
https://www.khanacademy.org/science/health-and-medicine/circulatory-system-diseases/shock/v/anaphylactic-shock

THANK YOU!

[sahai1]

thanks palmcity, that is a great explanation, especially I was confused how hypotension causes the tachycardia, and why the hypotension begins. 

It doesn't touch on the subject of desensitization at all though, and is written as if everyone is at risk, especially following a subsequent exposure to antigen.

If I understand correctly the anaphylactoid reaction is one where the IgE antibodies have already been created?   Or the body as already been sensitized? How long do the IgE antibodies stay docked on the basophils?

Can antigens combine to have a multiplied effect?  My wife had an idiopathic allergic reaction with hives and edema over a course of a few days about 2 weeks ago.  Perhaps I was storing some IgE antibodies from that which combined with the wasp antigen to create a more severe response.

[SeaWalnut]

The guy that fainted at the gas station,fainted because of his body released the adrenaline without being injected by a doctor.Adrenaline makes you feel skared and you breathe a lot more than normal wich oxigenates too much the blood .Then the body shuts down ,you faint for a few minutes without breathing, until the oxigen level in the blood reduces and when you wake up you feel good again= like a panic atack caused by the body own release of adrenaline.
Breathing fast and hyperventilating ,feeling skared and in good condition to drive the car ,its a sign that adrenaline got released.

[sahai1]

think your way off here seawalnut...

1rst.. Like palmcity mentioned the adrenaline (epinephrine) administered at the hospital slows the heart rate, because of effects on sympathetic nervous system in regards to the lungs.  I was administered epinephrine (adrenaline) at hospital to specifically lower my heart rate, by increasing oxygen flow.  After a few minutes after epinephrine shot, my heart rate went from 160 down to 80, so in fact adrenaline does not always increase heart rate, it's main function it would seem is to oxygenate the body in the best way possible.   

https://www.health.harvard.edu/staying-healthy/understanding-the-stress-response

The heart beats faster than normal, pushing blood to the muscles, heart, and other vital organs. Pulse rate and blood pressure go up. The person undergoing these changes also starts to breathe more rapidly. Small airways in the lungs open wide. This way, the lungs can take in as much oxygen as possible with each breath. Extra oxygen is sent to the brain, increasing alertness. Sight, hearing, and other senses become sharper.

So yes you are right, perhaps some adrenaline led to high heart rate in beginning, however this quickly wears off, and then comes the anaphylaxis shock.  The histamine causes vasodilation, in return hypotension, which leads to syncope.    I think the links are clear that this is not a disputable diagnosis.  The man at the gas station was well past the point of his own bodies adrenaline release and was experiencing severe hypotension.

[SeaWalnut]

Im talking about breathing not about the heart rate.Breathing faster than normal and deeper ,it was caused by adrenaline .
Its a desirable effect ,because he needed adrenaline.
The too much oxigen in the blood as a result from the adrenaline caused him to faint ( another desirable effect meant to protect your body in such cases).
While fainting ,he didnt breathe for a few short minutes wich lowered the too much oxigen from his blood.

[sahai1]

while searching hyperventilation leading to syncope, there is quote a lot of research about this.. but is it true in regards to anaphylaxis?  For example my vitals while in ER showed a low respiration rate, below 10, which was sending off the alarms to nurses who were monitoring my reaction to the epinephrine.  In this case my RR was showing alarms after the epinephrine shot.

Im talking about breathing not about the heart rate.Breathing faster than normal and deeper ,it was caused by adrenaline .
Its a desirable effect ,because he needed adrenaline.
The too much oxigen in the blood as a result from the adrenaline caused him to faint ( another desirable effect meant to protect your body in such cases).
While fainting ,he didnt breathe for a few short minutes wich lowered the too much oxigen from his blood.

[sahai1]

got 4 paper wasp stings today... one near wrist, two under the eye, and one on my back.  A bit of itchyness and swelling close to where stung, but otherwise fine.  Not sure why I'm so sensitive to yellowjackets.  I've never had any breathing issues with any other insects, and been stung by fire ants, centipedes, scorpions, giant water bug, over 100 bee stings at one time.

Will only really know more until a yellowjacket gets me, but won't be going out of my way to get stung!