Penicillin is characterized by strong bactericidal power and low toxicity, and is widely used in clinical practice. However, penicillin is prone to allergic reaction, 5%-6% of the population are allergic to penicillin, and allergic reaction can occur at any age, in any dosage form and dosage, and by any route of administration. Therefore, an allergy test should be done before the use of penicillin, and only those with negative test results can be used. Anaphylactic reaction Anaphylactic shock usually occurs in seconds or minutes after intradermal penicillin test or injection of the drug, or in half an hour, and rarely occurs in the course of continuous use of the drug. 1.Symptoms of respiratory obstruction Due to hypoxia and asphyxia, the patient subjectively feels chest tightness, laryngeal blockage with a sense of imminent danger, and objectively manifests shortness of breath, cyanosis, and foaming at the mouth. 2, circulatory failure symptoms, pale, cold sweat, weak pulse, blood pressure drop; 3, central nervous system symptoms due to hypoxia of brain tissue, the patient shows agitation, dizziness, face and limb numbness, loss of consciousness, convulsions, urinary and fecal incontinence. 4, skin allergy symptoms spasm, urticaria and other rashes. Serum sickness type reaction usually occurs within 7-12 days after the drug is administered, and the clinical manifestations are similar to those of serum sickness, with fever, arthralgia, itchy skin, urticaria, generalized lymph node enlargement, and abdominal pain. Allergic reactions of organs or tissues 1, skin allergic reactions mainly have rash (urticaria), severe cases can occur exfoliative dermatitis. 2, respiratory allergic reaction, can cause asthma or prompt the existing asthma attack. 3, digestive allergic reaction can cause allergic purpura, with abdominal pain and blood in the stool as the main symptom. The above symptoms can appear alone or at the same time, often with respiratory symptoms or skin itching the earliest, so we must pay attention to listen to the patient’s complaints. Second, intradermal test method 1, intradermal test solution preparation intradermal test solution containing 100-500u per ml of penicillin G isotonic saline solution as a standard (i.e., the concentration of the skin test solution is 100-500u/m1) Specific preparation is as follows: a bottle of penicillin (800,000u), for example, injected into the isotonic saline 2 ml of isotonic saline per m1 containing 400,000u, take 0,1 ml of isotonic saline added to 1m1 per ml containing 400,000u, containing 40,000u per ml of isotonic saline per ml containing 40,000u per ml containing 40,000u per ml containing 40,000u per ml containing 40,000u per ml. It contains 40 million u. Take 0,1 ml and isotonic saline to 1 ml, each ml contains 40 million u. Take 0,1 ml and isotonic saline to 1 ml, each ml contains 4 million u. Take 0,25 ml and isotonic saline to 1 ml, each ml contains 100 u. Each time the solution is prepared, it is necessary to mix the solution well. 2, Test method: Take penicillin skin test solution 0,1m1 (containing 10u) for intradermal injection, observe for 20 minutes, then judge the test result. 3, the results of the judgment negative: no change in the dermal mound, no redness around, no self-conscious symptoms; positive: the local dermal mound bulging, and the emergence of a red halo hard lump, diameter greater than 1cm, or red halo around the pseudo-foot, itchy, severe anaphylactic shock can occur. Precautions 1, before the test, ask the patient in detail about the history of drug use, allergy and family allergy history. 2.Anyone who uses the drug for the first time and then uses it again after 3 days of stopping the drug, as well as changing the drug batch number, must do the allergy test according to the routine. 3.The skin test injection must be freshly prepared, and the concentration of skin test solution and injection dose should be accurate; the solvent, syringe and needle should be fixed for use. 4, penicillin allergy test or injection should be done before the preparation of first aid (ready epinephrine hydrochloride and syringes, etc.). 5.Close observation of the patient, 30 minutes after the first injection to prevent the occurrence of delayed reaction. Pay attention to local and systemic reactions and listen to the patient’s complaints. 6.Positive test results prohibit the use of penicillin, and report to the doctor, in the doctor’s orders, medical records, bedside card on the positive reaction of penicillin allergy test is clearly indicated, and inform the patient and his family. First-aid measures for anaphylaxis 1. Rescue on the spot Immediately stop the drug, make the patient lie down, pay attention to warmth, and prick the middle of the human body with a needle. 2.Preferred epinephrine Immediately subcutaneous injection of 0,1% epinephrine hydrochloride 0,5 ~ 1m1, children with discretionary reduction, if the symptoms are not relieved, can be every half hour subcutaneous or intravenous injection of 0,5 ml, until out of the danger period, this drug is the first choice of drugs to rescue anaphylactic shock, which has a vasoconstriction, increase peripheral resistance, excitation of the myocardium, increase the cardiac output and the relaxation of the bronchial smooth muscle effect. 3.Correcting hypoxia to improve respiration Oxygen inhalation should be given, and when respiration is inhibited, mouth-to-mouth respiration should be carried out immediately, and respiratory stimulants such as nicosamide or lobeline should be injected intramuscularly. When laryngeal edema affects respiration, tracheal intubation or tracheotomy should be prepared immediately. 4.Anti-allergic antibody grams According to the medical advice, immediately give dexamethasone 5-10mg intravenous injection or hydrocortisone 200mg plus 5% or 10% glucose solution 500m1 intravenous drip, according to the condition of the pressure-raising drugs, such as dopamine, m-hydroxylamine and so on. If the patient has cardiac arrest, immediately perform extrathoracic cardiac extrusion. 5.Correct acidosis and antihistamines, apply according to medical advice. 6, close observation, detailed records Closely observe the patient’s temperature, pulse, respiration, blood pressure, urine output and other clinical changes. Make a good nursing record of the condition dynamics. The patient is not out of danger, should not be moved.