Distinguishing Acute Stress Response and Anaphylaxis

 

Acute Stress Response
(Vasovagal Syncope – VVS)

Anaphylaxis

At onset

VVS and General: occurs suddenly, before, at time of or soon after injection

Seconds to minutes after exposure, almost all cases within 1 hour

Skin

VVS and General:

Pale, cold, sweaty/clammy

Red, raised itchy rash, swollen eyes and face, generalized rash

Respiratory

VVS: normal to deep breaths
General: rapid deep breathing

Noisy breathing, wheeze or stridor, persistent cough

Heart

VVS: slow pulse, transient hypotension.
General: normal or fast pulse or hypertension

Fast pulse, hypotension

Gastro– intestinal

VVS: nausea, vomiting
General: nausea

Abdominal cramps, vomiting, nausea

Neurologic

VVS: transient loss of consciousness
reversed by supine position.
General: fearfulness, dizziness, numbness, weakness, tingling around lips, spasms in hands and feet

May develop loss of consciousness not relieved by supine position