Why this patient become unconscious?

Chief Complaint A 32-year-old male was stung on the left foot. The area started getting itch at the same time. Within 5-10 minutes he started getting skin rashes, chest tightness & breathlessness. History No past medical or surgical history. Vitals BP: 95/70 mmHg, Rapid, weak pulse Blocking breathing Physical examination He was unconscious & cyanotic when he reached the hospital and had 2 episodes of vomiting on the way. Diagnosis What are your comments? Treatment How should we proceed with the case step wise?

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SUGGESTIVE. OF ACUTE ANAPHYLACTIC SHOCK... And VASOVAGAL SYNCOPE... SECONDARY. TO INSECT. BITE. VENOM. REACTION

UNKNOWN BITES.. LEADING TO.. ANAPHYLACTIC SHOCK.. NEED'S.. IMMEDIATE HOSPITALIZATION AND.. LIFE SUPPORTING MEASURES..

Tnx Dr Ashok Leel sir
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This is due to anaphylaxis due to insect sting causes itching with redness locally associated with severe respiratory spasm causing chest tightness and breathlessness causing low oxygen saturation leading to cynosis and fainting. Pt needs urgent emergency care in ICU O2 support if necessary with positive pressure IV drip to continue Inj steroid in bus dose ist then to continue 2cc 8 hrly Inj Phenergan one amp stat inj. bronchodilator iv stat and sos Watch if the vitals Intake output chart to asses kidney function To watch for presence of any blood in urine to rule out haemolysis due poisonous snake bite.

Thanks Dr Dinesh Gupta
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Anaphylactic shock ( insect bite ) Iv infusion, Inj avil+ inj dexona 2ml each iv stat. Inj deriphylline 1 amp iv stat O2 inhalation. Resuscitation and regular monitoring and constant evaluation of vitals . Corrective measures to control BP, Pulse and HR. Look at site of bite and try to identify snake bite or any other insect.

Thanks Dr Kute Ankush
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Yes it is acute anaphylaxis Laryngeal stridor landing hypoxia and unconsciousness Hypotensive shock Ressucinate Intubation and maintain ventilation Inotropes keep vitals Antiallergics inj avil Try to identify the stung bite Ensured that it was not snake as line of treatment will change

Thanx dr Malinda Tarachand
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This is acute Anaphylactic shock... must give adrenaline and restore Airway and breathing at first. IV fluids and other supportive care. What kind of sting is also important.. bee sting or Snake bite or scorpion bite has different Lind of treatment...

Anaphylactic shock secondary to insect bite Patient is unconscious due poor cerebral perfusion IV steroid, SC adrenalin, IV crystalloids, IV antihistamines Need to identify the offending insect. Red ants and spiders are usual cause

Thank you Dr Arun Kumar Panda
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As far history concerned sugg vasovagal Shock /syncope ?sting bite unknown Need to matain ventilation nd hydration Spo2 saturation Cardiac monitoring Moniter urin out put Treatment of shock as per protocol Need intensive care

Possibly anaphylactic shock. Laryngeal spasm. Prefer subcutaneous adrenaline. Antihistaminics and steroids. Airways security Monitoring and maintain Circulation.

Patient is in Acute Anaphylactic shock

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