Investigating Anaphylactic Shock in Adults: Experiences From Writing and Exploration

Introduction

In the severe and often lethal condition of anaphylactic shock, which involves an allergic response, emergency healthcare presents an intractable problem. As this life-threatening medical emergency constitutes an urgent indication for timely intervention, prompt recognition and intervention are required to avert the worst consequences (Long & Gottlieb, 2021). Properly administering proper treatment is highly desirable in stabilizing the patient and reducing morbidity and mortality rates (Stukus, 2020). However, notwithstanding well-evidenced progress in the medical discipline and treatment options, anaphylactic shock still presents itself as a problematic condition, with its factors being complex and manifold and incredibly challenging in older people. This clearly emphasizes the need for tailored approaches against the available information (ROSS, 2021). Recognizing the fine−line differences of anaphylactic shock in the elderly is fundamental in improving successful treatment interventions and making the best patient outcomes.

The elderly age group poses particular difficulties in diagnosing and managing acute anaphylaxis. The prompt of the illness might heavily shift the clinical expression of skin responses and therapy responses in older patients with shelling allergies (“Epinephrine for first-aid management of anaphylaxis,” 2020). The assertion above should inform clinical practice guidelines by adequately understanding the intricacies underlying this phenomenon regarding their age (Cardona et al., 2020). This is crucial for improving treatment effectiveness and patient outcomes (Tanno et al., 2021). In addition, this introduction gives rise to the complete explanation of a pivotal part of hypothetical shock control: the early recognition and intervention specifically referring to elderly patients and their unique challenges.

In discussing the complexity of the diagnostic and management processes of anaphylactic shock in older people, individualized approaches must be implemented to accommodate their unique requirements (“Review for “food‐induced anaphylaxis morbidity: Emergency department and hospitalizations data support preventive strategies,” 2021). Factors like age-related changes in immunity function can make it hard to demonstrate or respond to anaphylaxis in this population (Krishnaswamy, 2021). In addition, prior clinical conditions and drug use alongside the treatment can have an impact on the occurrence of anaphylaxis (Dodd et al., 2021). These factors, hence, call for detailed awareness for HCPs to spearhead the swift and accurate response to elderly patients who are manifesting shock induced by anaphylaxis (Whyte et al., 2022). To accomplish the knowledge gap, this introduction seeks to feature the various problems that elders with anaphylaxis go through in management (Galletti & De Paiva, 2021). Ultimately, the focus is on ensuring these patients have a quick and sure recovery journey.

This process becomes effective by specifying separate databases such as CINAHL (Cumulative Index of Nursing and Allied Health Literature) and PubMed to find the coverage of the literature sources about anaphylactic shock. These databases are golden sources for healthcare professionals, researchers, and scholars alike, allowing them to search through collected peer-reviewed articles covering different healthcare topics(Morse-Brady & Marie Hart, 2020). Utilizing systematic searches that employ a mixture of keywords and terminology unique to the selected study area, researchers will obtain an evidence-based review of the evidence-based literature to make well-informed decisions in emergency care and advance knowledge in the field. CINAHL, through the specialization on nursing, health sciences, and allied health disciplines literature, offers the most appropriate publication for nurses’ clinical Practice and patient care. On the contrary mode, PubMed, which holds a unique niche as an outlet for research publications encompassing a wide range of biomedical topics, presents the chance to access broader areas of medical specialties and domains of research; therefore, the depth of the evidence has been acquired. Moreover, the databases offer advanced search functions and specialized filters, which makes it easier for researchers to minimize the number of articles downloaded, selecting those meeting the criteria from the research question. Thus, it is possible to reveal the most relevant articles available on a subject.

Bringing it to the specific problem of anaphylactic shock, extensive browsing of the literature in CINAHL and PubMed is an excellent means to better understand research publications on different sides of this critical state, for instance, etiology, clinical presentation, management, and outcomes. The databases showcase the true potential of the Internet by enabling advanced search features and implementing particular filters that make the research process easy and enjoyable. CINAHL has a specific mission of serving the nursing and related health discipline population, consequently providing the practitioners with articles that are not only connected to these fields but also highly concerned with clinical Practice and patient care during the occurrence of anaphylactic shock. With a simple click, researchers can delve into research papers that provide ample details about nursing interventions and underlying causes of anaphylaxis based on experiences from various allied health professionals and medical management practices. Contrary to that, PubMed’s wide association with biomedical subjects gives it more specialties than general medicine and other domains of fieldwork. The variety of evidence available (derived from different sources) allows researchers to undertake the multi-vision of anaphylaxis involving the medical science field, including immunology, emergency medicine, and pharmacology.

Generally speaking, this section is crucial in becoming aware and acting early to combat anaphylactic shock, mainly in elderly patients, and drawing attention to the databases is as vital as the quality of evidence. Practitioners should use thorough database tools such as CINAHL or PubMed for their research to improve patient outcomes and enhance the quality of care in day-to-day dispensaries. These databases facilitate the search for scientifically valid information by healthcare providers and allow the delivery of evidence to the point of care, where interventions can be enacted in an informed way. Finally, deploying professionally designed databases brings new trends in emergency care expertise, and the best practices in the healthcare industry are set to be upgraded.

Purpose Statement

This literature research aims to investigate whether early recognition and management of anaphylactic shock reduce mortality rates and hospital stays. The rationale behind building the PICOT question is to ascertain whether early intervention in early anaphylactic shock is evidence-based. This helps turn to patient outcomes but identifies the gap in knowledge at this moment. Here, the researcher will derive the results from the overall PICOT issue.

PICOT Question

This is an intervention-oriented question, detecting how prompt diagnosis and interventions in a state of anaphylactic shock enhance the survival rate and reduce the average length of stay in the hospital. The most appropriate degree of evidence that helps answer this question would be randomized controlled trials (RCTs) or systematic reviews/meta-analyses of RCTs.

Databases and Search Strategy

CINAHL and PubMed, two revered databases, were exhaustively studied with systematized search strategies. This entailed using relevant keywords such as “anaphylaxis” and “emergency department” and the Boolean operator of “RCT ” to ensure thorough coverage of the relevant literature. On the other hand, a narrow base of research results with the help of a strict limiter were articles that have been peer-reviewed, published within the last five years, and written in English, which focus on adults 45 years and older. The search strategy considers articles such as RCTs (randomized controlled trials) and systematic reviews/meta-analyses of RCTs. CINHA was explored, but PubMed later got articles that fulfilled the rigorous inclusion criteria from January 2019 to the present date. To maintain the integrity of the study, specific attention was paid to the most recent and meaningful literature on anaphylactic shock treatment in the target population chosen. This aim was met by ensuring the robustness and reliability of the study through research findings.

Search Terms

Respective search terms, such as “anaphylactic shock,” “emergency department,” and “intervention,” are the pieces of the all-encompassing PICOT question. The inclusion of synonyms and variances in spelling throughout the Query aimed to enhance the extent of the search. The AND operator weeded out startup solutions, while OR showed the full spectrum when required. The search entailed Query stemming, nesting, and functioning methods to increase the accuracy. These approaches promptly search for the relevant literature and then use this to answer the question appropriately. The words were searched for via several search engines; thus, the searched words were related to the PICOT question and covered various aspects.

Inclusion and Exclusion Criteria

The inclusion criteria for this study were carefully selected to ensure relevance and quality. Specifically, the focus was on English-language, peer-reviewed articles published within the last five years, explicitly emphasizing antibiotic-induced anaphylaxis within emergency department settings and limiting the search to this timeframe and language aimed to access the most current and reliable evidence available. Additionally, prioritizing peer-reviewed articles helped maintain the research quality and credibility standard. Conversely, exclusion criteria were applied to filter out studies that did not directly address antibiotic-induced anaphylaxis or were conducted outside the emergency department setting. This stringent approach aimed to streamline the search process and ensure that only the most pertinent literature was included for analysis.

Search Process

The selection of inclusion criteria for this study considered pertinence and whether it is the right fit—emphasis on English-language articles published in peer-reviewed journals over the past five years. Preferably, there is new evidence about anaphylaxis induced by antibiotics in the emergency departments. Furthermore, publishing only articles that have gone through the peer-review process ensures the highest possible quality of the research standards and credibility. However, there was an application of exclusion criteria to restrict studies that did not concern antibiotic-associated anaphylaxis and whose authors did not concentrate on the emergency department setting. This rigorous approach tried to simplify the search process and enhanced the probability of reviewing accurate literature that provides input to the analysis.

Selection of Final articles

These two sources provide a post-genomic era approach to the early identification and immediate response to anaphylactic shock. They cover the topic in-depth, maintain uniformity of insights and evidence-based data, and are categorized as highly reliable. The first paper, “Anaphylaxis in Elderly People” by Ventura et al. (2022), focuses on an optimistic and detailed review of the delicacy of the subject, highlighting how it differs from the younger generation. A case study, such as one based on data collected from the European Anaphylaxis Registry, will have an input on the frequency, risk factors, presentation, and management plan tailored for older adults facing anaphylactic shock. It highlights the cardiac life support measures and the efficiency of the primary airway, breathing, circulatory, disability, and exposure (ABCDE) flow. This exceptional medical crisis management allows older patients to be well and rapidly taken care of. Notably, it also highlights secureness and the need for healthcare servicing providers, on which participants show preparedness or alertness.

The protocol becomes effective as databases incorporate CINAHL (Cumulative Index of Nursing and Allied Health Literature) and PubMed, where they find the existing literature about Anaphylactic Shock. Such databases are, therefore, the treasure houses for physicians, researchers, and scholars who spend endless hours browsing articles on medical topics mostly accepted by the scholarly community. Investigators will implement a systematic search approach encompassing the combination of terminology and keywords particular to the chosen study domain to acquire an evidence-based literature review based on the evidence to develop logically informed choices in emergency care and advance the knowledge in the respective field. CINAHL provides a foundation on nursing, health sciences, and clinical practices and can be a trusting resource for nurses to access quality articles and information applicable to nurse clinical practice and patient care. Relative to the JAMA platform, PubMed, a journal that holds the privilege of out letting research publications across various specialties in biomedicine, provides the opportunity to represent the area of medicine more profoundly and, therefore, transfer knowledge gained. Concurrently, the databases provide several advanced search settings and also offer to save time selecting articles that meet research questions using those settings. Consequently, we can discover the most significant articles that will contribute to a better understanding of the reported event.

References

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Dodd, A., Hughes, A., Sargant, N., Whyte, A. F., Soar, J., & Turner, P. J. (2021). Evidence update for the treatment of anaphylaxis. Resuscitation, pp. 163, 86–96. https://doi.org/10.1016/j.resuscitation.2021.04.010

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