Allergic reactions
 
 
 

Definition of Anaphylaxis
Anaphylaxis is a systemic reaction, meaning that it is not a local reaction such as a swollen eye; it incorporates the entire body system. Anaphylaxis kills by a rapid fall of blood pressure and swelling of the throat.

Symptoms of Anaphylaxis (**Please see notes at bottom)
Textbook Symptoms:

  • Itching all over
  • Hives, blisters, redness on skin (can be apparent anywhere on body)
  • Quickened but faint pulse and heart palpitations
  • Generalized swelling under the skin – this is due to fluid escaping from the blood vessels into the tissue
  • Tightness in throat
  • Difficulty in breathing, speaking (hoarseness), and swallowing
  • Coughing, wheezing
  • Eye swelling, nose blockage and sometimes sneezing
  • Flushed face
  • Warm feeling throughout body
  • Sense of doom** (see notes at bottom)
  • Dizziness/faintness and potentially collapse (because of blood pressure dropping)
  • Anxious, fearful and confused
  • Abdominal cramping
  • Nausea and vomiting

Level of Anaphylactic Reaction
The level of the reaction can be considered mild, moderate or severe. Mild anaphylaxis would incorporate hives, itchiness, swelling of eyes and lips and some congestion.

Moderate anaphylaxis would be worsening of mild symptoms, accompanied by flushing and feeling of warmth, labored breathing, as well as nausea and vomiting.

Severe or full-blown anaphylaxis is life threatening, which involves severe swelling, blockage of airflow and the upper airway begins closing. This in turn causes wheezing and asthmatic attack. When the cardiovascular system is in anaphylaxis, it causes extensive fluid leakage from the blood vessels into the tissues. This results in decreased blood pressure and shock.

Immediate First Aid For Anaphylaxis
Inject adrenaline (see EpiPen® for instructions). If asthmatic, use inhaler also.

If there is swelling in the tongue and the person is unconscious or becoming oxygen deprived (turning blue), attempt to keep the trachea (main airway opening from the throat) open by tilting the base of the neck forward and tip the head slightly forward.

If there is swelling in the person’s throat, have them sit not lie-down. If they lose consciousness, then need to be placed in the standard recovery position (on their side) so they do not risk inhaling vomit.

Important Anaphylaxis Information
If your child has asthma, ensure it is very well controlled always. Most people who succumb to Anaphylaxis are asthmatics whose asthma was not completely controlled.

No matter how mild the onset of the reaction appears to be - it must be treated immediately - if you wait to see if the symptoms progress, it could be too late.

Hospital treatment is absolutely essential. Even if you have used your EpiPen® or other injector you must receive medical care immediately.

Under medical attention, you will likely be monitored for a several hours as a biphasic anaphylactic reaction (second set of symptoms) could occur. A biphasic reaction usually occurs between 4 and 8 hours after the initial reaction.

Currently, there is no record of a fatal reaction from airborne particles as the allergen must be ingested.

Most anaphylaxis related to food-related allergies occurs when eating away from home. Recognition and treatment of anaphylaxis makes the difference between life and death.

The essential keys to successfully managing anaphylaxis are knowledge and preparedness. If you are unaware of the symptoms, you may not recognize them quickly enough and your treatment could come too late. Alternatively, if you are knowledgeable, but are not prepared, you cannot react quickly enough either. Always be prepared!

Generally speaking, if in doubt of a reaction, treat it with adrenaline. It is better to over-treat a reaction that under-treat it.


**NOTE: I had the opportunity to speak with a well-informed physician regarding anaphylatic reactions and mentioned that I had read much information that lead me to believe that one should always use an EpiPen, as an antihistamine may mask full-blown anaphylaxis.

He felt that in no way is that true - nothing can stop symptoms of an anaphylactic reaction other than epinephrine. Please speak to your family doctor or allergist and get their input on this issue to help you prepare your Emergency Plan.

**NOTE: Please note that these symptoms are general and "textbook" case. It is said in the following study that children very rarely describe "textbook" symptoms. That is because they are children and cannot define "impending doom" or terms of the like.

The following excerpt is taken from a pediatric study off "medicalpost.com":

"In young children, symptoms are going to be described using a non-traditional vocabulary, using no word that you'll ever read so far in a medical textbook, although with this study, we will change that," Dr. Simons said.

Skin was involved in 91% of cases. But she said that "itch" is difficult for very young children to describe. "We got reports of children complaining of pain, throbbing, hurting, tickling, tingling, burning—all sorts of euphemisms for 'itch.' " Parents or caregivers deduced the children were itchy when they saw the children rubbing or "frantically clawing" skin.

However, Dr. Simons said she was particularly concerned about the 9% of episodes where skin wasn't affected. "If you're faced with a child with multiple signs and symptoms, often it's the presence of the urticaria that's so helpful in confirming for the doctor that anaphylaxis is taking place. If there is nothing present or visible in the skin, it's a much more difficult diagnosis to make clinically."

Central nervous system was involved in 3% of episodes. "We learned in medical school about that feeling of impending doom that occurs when people are having anaphylaxis," Dr. Simons said. "Not one case report in this series involved a feeling of impending doom, but there were many descriptions of children becoming agitated, panicked, frightened or crying inconsolably."

Among gastrointestinal symptoms (which occurred in 43% of episodes), nausea was relatively uncommon, possibly because young children don't have the vocabulary to describe it, she added.

Other signs and symptoms were respiratory (69%), cardiovascular (8%), nasal (8%) and ocular (5%).

 
 
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