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.
 It happened again. A 14-year-old boy with a known peanut allergy ate a granola bar at school, showed signs and symptoms of anaphylaxis, and did not survive. Allergic reactions to food are common at school. One in 12 children come to school with a food allergy. Of those, 18% have at least one reaction within the span of two years. Anaphylaxis is an acute, life-threatening allergic reaction to a substance to which the body has become hypersensitive. It usually involves food, insect venom, medication or latex. Mild allergic reactions do occur. A few hives or an eczema rash may appear – these are common mild symptoms. An itchy nose, mouth or eye symptoms and some stomach discomfort are also typical mild symptoms. Treatment for a mild allergic reaction varies. Usually a medical professional prescribes an antihistamine and there is time to wait to see if things get better. Anaphylaxis is different. It is typically diagnosed when severe allergy symptoms affect two or more body organs. Anaphylaxis can be difficult to identify in the school setting. For someone with a known allergy, when the following symptoms are seen, think anaphylaxis:
Treatment for anaphylaxis needs to be immediate. The first and only treatment is epinephrine. There is no other drug. Just one. Talk with your doctor about a prescription for an epinephrine auto-injector.
Remember... EPINEPHRINE FIRST, EPINEPHRINE FAST.
What is Epinephrine? Epinephrine, also called adrenaline, is a naturally occurring hormone in your body that is part of your body’s fight-or-flight response. Epinephrine will stop the symptoms of anaphylaxis – a life-threatening allergic reaction. What does epinephrine do?
Epinephrine is safe to use for most people. It is the first line of defense to treat anaphylaxis. What are the common side effects of epinephrine?
How should epinephrine be stored?
Epinephrine Helpful Tips:
If you need to use epinephrine:
A respected allergist once said, “If you say to yourself, ‘I wonder if I should give the…‘ and ‘epinephrine’ is the next word, don’t finish the sentence – give the epinephrine.” The risk is not in giving epinephrine, it is in DELAYING the use of epinephrine. If someone dies from anaphylaxis, it is usually due to the delay in administering epinephrine. We don’t know all of the circumstances in this latest tragic death from anaphylaxis. We do know that school nurses and school staff need to be ready to respond to an allergic emergency. School nurses, teachers, coaches and other school staff should be trained to…
Allergy & Asthma Network has food allergy management resources available to assist school nurses and staff. Preschool and daycare workers also need to be aware of food allergies. New York, Illinois and Virginia adopted Elijah’s Law to require daycares to develop guidelines for identifying and preventing anaphylaxis. This includes training and strategies to reduce exposure to food allergens. Pennsylvania and California are considering versions of Elijah’s Law. If you live in those states, you can get involved by telling your legislator to support the legislation.
Don't forget... EPINEPHRINE FIRST, EPINEPHRINE FAST. Patient Story: Why Minutes Count with AnaphylaxisThe following was written by Sandra Fusco-Walker, Allergy & Asthma Network’s Director of Outreach from 1996-2003 and Director of Patient Advocacy from 2003-2013. As a patient advocate for 20+ years, I’ve met so many families who have lost loved ones to anaphylaxis. Those who died had one thing in common. They didn’t use epinephrine. Either they weren’t aware they had a severe allergy and never had a prescription, they forgot to carry it, or they thought they did not need it anymore. National guidelines emphasize epinephrine is the first line of treatment for anaphylaxis. Using it makes the difference between life and death … and minutes count. My mantra as an advocate was always, “When in doubt, give the shot!” The medication won’t harm you if you really don’t need it – but anaphylaxis will, and it just might save your life. In the back of my mind, I wondered about the qualifier that medical professionals added when I asked about safety … “Epinephrine won’t kill them, but if they have a weak heart, maybe an older person – epinephrine might be a problem.” On July 19, 2014, I knelt beside my 63-year-old husband, Scott, the only one in our family with no history of allergies or anaphylaxis. He was writhing on the ground drenched in sweat. He was retching and barely conscious 10 minutes after some yellow jackets stung him. I held an epinephrine auto-injector in my hand and hesitated. Even though all the symptoms were there, right in front of me, I started questioning myself. Should I wait for the ambulance? Should I give him the shot? Is his heart strong? I remembered the ending to those conversations about safety – “If they’re already dying from anaphylaxis, a heart attack doesn’t really matter, does it?” – and I plunged the device into my husband’s thigh. I counted off 13, my lucky number. As I pulled the device away, I watched the red rash on Scott’s arms solidify to blotches. Ten minutes later, EMTs arrived with more epinephrine and gave him a second shot. By the time Scott entered the emergency room, he was lobster red from his head to his feet. Except for his fingers and toes – they looked black, apparently from the lack of oxygen in his blood. The emergency department team worked their magic. Later the doctor told us it was the quick use of epinephrine that saved Scott’s life. We are grateful to everyone who taught us so much at Allergy & Asthma Network. I’m especially grateful to those families who, despite their grief, bravely shared their experience in the hope that others wouldn’t lose their loved ones, too. Your message was loud and clear. And it saved a life. Reviewed by: |
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