FIRST AID FACT SHEETWhat to do in the case of Anaphylaxis
A severe allergic reaction is the body’s immune system overreacting to a foreign substance. This is called Anaphylaxis and is potentially life-threatening.
What to do
Caused by
Signs and symptoms
Anaphylaxis is a severe allergic reaction that needs to be treated right away. If you have an anaphylactic reaction, you need an epinephrine (adrenaline) shot as soon as possible, and someone should call 911 for emergency medical help. Left untreated, it can be deadly. Epinephrine can reverse the symptoms within minutes. If this doesn't happen, you may need a second shot within half an hour. These shots, which you need a prescription to get, come pre-filled and in ready-to-use pens. You shouldn’t take an antihistamine for an anaphylactic reaction. Anaphylaxis is rare, and most people recover from it. But it's important to tell your doctor about any drug allergies you have before any kind of medical treatment, including dental care. It’s also a good idea to wear a medical alert bracelet or pendant or carry a card with information about your allergy. If you've had an anaphylactic reaction before, you have a higher risk of having another one. You also have a higher risk if you have a family history of anaphylaxis or have asthma. The first signs of an anaphylactic reaction may look like typical allergy symptoms: a runny nose or a skin rash. But within about 30 minutes, more serious signs appear. There is usually more than one of these:
Some people also remember feeling a "sense of doom” right before the attack. Symptoms can move to shock and loss of consciousness. As many as 1 out of every 5 people may have a second anaphylactic reaction within 12 hours of the first. This is called a biphasic anaphylaxis. Epinephrine is the most effective treatment for anaphylaxis, and the shot should be given right away (usually in the thigh). If you’ve had an anaphylaxis reaction before, you should carry at least two doses of epinephrine with you at all times. Epinephrine expires after about a year, so make sure your prescription is up to date. If you have an anaphylactic reaction and the pen has expired, take the shot anyway. When medical personnel arrive, they may give you more epinephrine. If you’re not able to breathe, they may put a tube down your mouth or nose to help. If this doesn’t work, they might do a kind of surgery called a tracheostomy that puts the tube directly into your windpipe. Either in the ambulance or at the hospital, you may need fluids and medications to help you breathe. If the symptoms don't go away, doctors may also give you antihistamines and steroids. You probably will need to stay in the emergency room for several hours to make sure you don't have a second reaction. After the initial emergency is over, see an allergy specialist, especially if you don't know what caused the reaction. Anaphylaxis happens when you have an antibody, something that usually fights infection, that overreacts to something harmless like food. It might not happen the first time you come in contact with the trigger, but it can develop over time. In children, the most common cause is food. For adults, the main cause is medication. Typical food triggers for children are:
Common food triggers for adults are:
Some people are so sensitive that even the smell of the food can trigger a reaction. Some are also allergic to certain preservatives in food. Common medication triggers are:
Anaphylaxis also can be triggered by a few other things. But these aren’t as common:
Some people can have an anaphylactic reaction if they breathe in latex. Some can have a reaction to a combination of things:
In rare cases, it can be triggered by 2 to 4 hours of exercise after eating certain foods or by exercise on its own. Anaphylactic reactions usually start within minutes of contact with the trigger, but they can also happen an hour or more later. Some people never figure out what caused their reactions. That’s known as idiopathic anaphylaxis. If you don’t know your triggers, you can’t avoid them. So it’s especially important to carry epinephrine injectors, make sure you and people close to you know how to use them, and wear medical alert jewelry. What is anaphylactic shock? For some people with severe allergies, when they’re exposed to something they’re allergic to, they may experience a potentially life-threatening reaction called anaphylaxis. As a result, their immune system releases chemicals that flood the body. This can lead to anaphylactic shock. When your body goes into anaphylactic shock, your blood pressure suddenly drops and your airways narrow, possibly blocking normal breathing. This condition is dangerous. If it isn’t treated immediately, it can result in serious complications and even be fatal. Anaphylaxis is caused by an overreaction of your immune system to an allergen, or something your body is allergic to. In turn, anaphylaxis can result in anaphylactic shock. Common triggers for anaphylaxis include: In rare cases, exercise and aerobic activity such as running can trigger anaphylaxis. Sometimes a cause for this reaction is never identified. This type of anaphylaxis is called idiopathic. If you aren’t sure what’s triggering your allergy attacks, your doctor may order an allergy test to look for what’s causing them. Risk factors for severe anaphylaxis and anaphylactic shock include:
Anaphylactic shock is extremely serious. It can block your airways and prevent you from breathing. It can also stop your heart. This is due to the decrease in blood pressure that prevents the heart from receiving enough oxygen. This can contribute to potential complications such as: In some cases, you’ll experience a worsening of pre-existing medical conditions. This is especially true for conditions of the respiratory system. For example, if you have COPD, you may experience a lack of oxygen that can quickly do irreversible damage to the lungs. Anaphylactic shock can also permanently worsen symptoms in people with multiple sclerosis. The sooner you get treatment for anaphylactic shock, the fewer complications you’re likely to experience. If you’re experiencing severe anaphylaxis, seek emergency care immediately. If you have an epinephrine auto-injector (EpiPen), use it at the onset of your symptoms. Don’t try to take any type of oral medication if you’re having difficulty breathing. Even if you seem better after you use the EpiPen, you must still get medical attention. There’s a significant risk of the reaction coming back as soon as the medication wears off. If anaphylactic shock is occurring because of an insect sting, remove the stinger if possible. Use a plastic card, such as a credit card. Press the card against the skin, slide it upward toward the stinger, and flick the card up once underneath it. Don’t squeeze the stinger, as this can release more venom. If someone appears to be going into anaphylactic shock, call 911 and then:
The first step for treating anaphylactic shock will likely be injecting epinephrine (adrenaline) immediately. This can reduce the severity of the allergic reaction. At the hospital, you’ll receive more epinephrine intravenously (through an IV). You may also receive glucocorticoid and antihistamines intravenously. These medications help to reduce inflammation in the air passages, improving your ability to breathe. Your doctor may give you beta-agonists such as albuterol to make breathing easier. You may also receive supplemental oxygen to help your body get the oxygen it needs. Any complications you’ve developed as a result of anaphylactic shock will also be treated. Anaphylactic shock can be extremely dangerous, even fatal. It’s an immediate medical emergency. Recovery will depend on how quickly you get help. If you’re at risk for anaphylaxis, work with your doctor to come up with an emergency plan. Long term, you may be prescribed antihistamines or other allergy medication to reduce the likelihood or severity of future attacks. You should always take the allergy medications prescribed to you by your doctor and consult them before stopping. Your doctor may suggest carrying an EpiPen in case of a future attack. They may also help you identify what caused the reaction so you can avoid triggers in the future. |