Urgent notice about the reaction to the vaccine is directed to the local SES, then
REG SES, and after the institute named Tarasevich. After receiving a certain
number of such notification addressed the question of the fate of this series
vaccine.
will or will not reaction - to predict them is extremely difficult. This is due
that the reaction to the vaccine depends on many factors: health status
child, the degree of reactogenicity of the vaccine and the quality of its storage and route of administration,
against which planted, how to prepare for vaccination. Predict a very
difficult. Attempts were carried out and there are positive developments.
Complications:
Uvelicheine in the size of the thymus gland may be associated with the syndrome of sudden
death. And the immediate cause of it - serve as a sudden spasm or violation
patency vozduhoprovodyaschih tract, bronchospasm, cardiac arrest, paroxysmal
tachycardia, heart block, etc.
In St. Petersburg, a team of researchers led by Tsinzerlingom has worked
to study a retrospective analysis of death from an increase in the thymus. Must
ongoing monitoring - and as death during the night - to put sensors,
which would have signaled to stop the heart. The syndrome of sudden death observed
at thymomegalia. Therefore, you should investigate the X-ray of the chest
cells in two projections - the direct and lateral. Alternative Diagnosis - Uzi
thymus and thermography. You can see an increase, the seal, as well as local
hyperthermia at 1-2 ° C and above.
Mechanisms of post-vaccination reactions.
All reactions were divided on the reaction of the immediate and delayed type. Almost
All states are the immediate consequence of immediate allergic reactions
type. Released from mast cell granules shock toxins - histamine, serotonin,
bradykinin, plasmin, heparin, in normal conditions are necessary substances
and in adequate quantities govern in his place of homeostasis. Since serotonin
reduces the terminal division of the vessel, bradykinin - maintains vascular tone,
Histamine - regulates digestion and immunity. Release (liberatsiya)
and the subsequent effects on receptors volley (explosively) release of biologically
active substances cause severe allergic reactions. Liberatore can
be any substance, including and vaccine antigens.
RIL (immunoleykotsitoliza reaction) is based on mixing of antigen and the baby's blood
in vitro. The death of 20% ormorecells indicates a high level of sensitization
to this antigen and possibly explosively release of biologically active
substances. About to judge the degree of cytolysis in the body of the child and the level of
the possible release of biologically active substances in the blood.
history is important - whether before an allergic reaction to any substance
vaccination, the introduction of seasm immunoglobulins in the child and his parents
or other family members.
Most allergic reactions and anaphylactic shock occur when re-
introduction of a resolution doses of antigen, but probably on a single of its introduction.
Power of allergic torate does not directly depend on the piped dose of antigen.
There is no clear-cut, depending on where and how to introduce an antigen - a / k
n / k / m, in / in / a. Certainly the case with great severity in / or / and the introduction,
but may be in contact with mucous membranes.
Survey (CBC, thermometry, ultrasound examination of the thymus, RIL, history) gives
some effect, but it still is not sufficiently reliable.
Anaphylaxis - occurs very quickly (minutes) after injection
resolving dose of antigen. Sometimes there are harbingers - pain at the injection site,
intense redness of the skin, soft tissue swelling. In some cases - a asnny nose,
watery eyes, itchy skin or itching of the mucous. In connection with the instant release of shock
toxins decreases vascular tone, decreases blood pressure due to increased permeability
vessels (histamine). Upset the microcirculation in the capillaries. Reduced bcc
and increased permeability. increases dyspnea, tachycardia, phenomena associated
with edema and swelling of the brain substance. If the assistance provided is delayed, the extent of
severity of the condition is progressively increasing. Increasing disorder of regulation
cardiovascular and respiratory center - violated the activities of vital
functions, and progressively deteriorating.
sample list of dasgs needed to provide medical
assistance.
Presornye amines:
Respiratory analeptics:
Water-soluble corticosteroid hormones:
Cardiac glycosides:
Anticonvulsants:
Antipyretics:
need to monitor the recasitment, change after expiry date medicines
and renew as necessary.
ADRENALIN : reduces the resorption of the injection site. It is therefore necessary
conduct obkalyvanie. Dilute adrenaline - 1 ml + 9 ml of saline solution. Cut away
from several points. Correctly obkolotoe place pales and becomes colder.
You can apply ice. Repeated obkalyvanie 15 - 20 minutes. Can be repeated
several times.
If injections were made in a limb, it is necessary to isolate it, put it
burn for a short time 1-1,5 hours.
effects on vascular tone and restore bcc:
Norepinephrine is introduced only by intravenous injection, slow infusion. Then, to restore
BCC introduction krovezamenyayuschie solutions - gemodez, polyglukin, reopoliglyukin,
neokompensan, makrodez.
fight with a local or generalized brain swelling:
saluretics (Lasix, furasemid) at 2-5 mg / kg but not less than 10 mg in the first introduction
- IV.
osmotically active substances which return fluid from the tissues into the vascular
channel: glucose 10%. With omission of the situation may be break-cerebellar tonsils
in the foramen magnum.
If there is a convulsive syndrome in / enter GHB - 50-100 mg / kg 20% solution
- 0,5 ml / kg / day.
to improve the microcirculation of esters of nicotinic acid - trental; Teonikol,
komplavin, ksavin.
Respiratory analeptics - etimizola hydrochloride 1-1,5 mg / kg. Stimulate
respiratory center, the adrenal cortex, pressor effect.
Glyukokrtikoidnye hormones - protective effect - Protectors for antigen-antibody reaction
and reduce libiriasyuschy effect of immune complexes on the cells and release of
biologically active substances - hydrocortisone, prednisolone, solyumedrol.
Cardiac glycosides. After stabilization of blood pressure - Translation
intensive care unit or intensive care unit because perhaps undulating
during the process.
Angioedema : Tendency to it genetically determined (within
one family). Edema may be local, people-century ear, larynx,
language infarction. Maybe at the injection site.
Syndrome Lyell : characterized by bullous process of the skin - occur
bubbles, then erosion. Tends to samorazresheniyu - with exudate, and follows a / r,
but lost a lot of fluid. Looks like a burn. Lesion obrabatvayut
fukartsinom cautiously.
Stevens - Johnson : there are a rash around the natural
holes.
Laws assistance, as well as with anaphylactic
shock.
treatment and at the same seasm sickness: corticosteroids, antihistamines
dasgs; cardiac glycosides, respiratory analeptics, pressor amines.
number of "guilty" of antigens derived through the digestive tract - giving Enterosorbents:
activated charcoal, cholestyramine, enterosgelya, vazozana to 1 powder 3 times
per day. Do not combine with other oral medication.
BCG - vaccination adverse reaction: c / o 6 months or more. One of the complications
- Osteomyelitis. To prove this - a selection from the hearth vaccine strain. Possible
sepsis. Receiving ftivazida. To treat seizures (as a complication
dasg treatment) - to provide vitamin B6, or pyridoxal phosphate.
fact that the reaction is entered in an outpatient card!
Fill emergency notification. Then forwarded to the SEA. Under investigation
with the participation of an epidemiologist SES, hospital administration, immunology (pediatrician).
Drawn up investigation postvaccinal adverse reaction.