Anaphylaxis (ana-fil-ak-sis) is a severe allergic reaction. Every year, millions of Americans have a reaction that can result in adverse or even fatal outcomes, increased health care costs, and reduced workplace productivity. It is estimated that the number of these reactions has been increasing, and the cause for this increase is unknown.
Anaphylaxis can be triggered by a wide range of allergens, such as food allergies, insect venom (e.g., bee stings), latex (especially in people who wear latex gloves at work), and medications.
The potential risk of an anaphylactic reaction occurring in an employee or a customer exists for employers — especially those providing food services or vending machines on the worksite, as well as employers with outdoor workers. Further complicating matters, is the fact that many people with allergies don’t know that they have an allergy until the reaction occurs or which allergens trigger severe life-threatening reactions.
The signs and symptoms of an anaphylactic reaction may include one or more of the following:
• Sudden hives
• Lip swelling
• Trouble breathing or wheezing
Strict avoidance of known allergens must be the first line of defense in reducing the risk of anaphylactic reactions. Additionally, if you or a family member are allergic, it is important to
have a food allergy management plan in place.
The most common causes of anaphylaxis are:
· Foods, including peanuts and tree nuts (particularly almond, walnut, hazelnut, Brazil, and cashew nuts)
· Shellfish, especially shrimp and lobster
· Dairy products
· Insect stings, such as those from wasps, bees, ants
In some cases, anaphylaxis can also be caused by exercise, usually after eating certain foods that trigger your allergy.
An anaphylactic reaction can occur suddenly and is potentially life-threatening. If you think that you or a family member may be at risk for anaphylaxis, check with a doctor.
Can anaphylaxis be prevented?
Preventing anaphylaxis is the ideal form of treatment. However, that may not always be easy since insect stings are frequently unanticipated, and allergens in foods are often hidden in a variety of different preparations. A consultation with an allergist is vital in helping you identify the trigger(s) and providing you with information and instruction on how to best avoid them. You will learn how to use emergency kits and how to become prepared for any reaction in the future.
These are three situations in which preventive treatment might be offered by the allergist.
Allergy shots may be suggested to some people with wasp, yellow jacket, hornet, honey bee, or fire ant reactions. This form of treatment gives 98% protection against the first four insect reactions, though somewhat less protection against fire ant reactions.
Pre-medication is most helpful in preventing anaphylaxis from X-ray dyes. Alternative dyes that are less likely to cause reactions may be available.
Desensitization to problematic medications is often effective. This process is accomplished by gradually increasing the amount of the medication given under controlled conditions. Sensitivities to penicillin, sulfa drugs, and insulin have been successfully treated in this way.
Anyone known to be at risk for anaphylaxis should wear a Medic-Alert bracelet that clearly states the allergic trigger, the risk of anaphylaxis, and the availability of an epinephrine kit.
People with anaphylaxis to medications should take new medications by mouth whenever possible since the risk of anaphylaxis is higher with injections.
Basic Avoidance Measures for Anaphylaxis
|Drugs/Medications||Advise all health-care personnel of your allergies.Ask your doctor whether the prescribed medication contains the drug(s) you are allergic to.Take all drugs by mouth if possible.|
|Insect Stings||Avoid areas such as outdoor garbage, barbecues, and insect nests.Avoid bright clothing, perfume, hair spray, or lotion that might attract insects.Wear long-sleeved clothing, long trousers, and shoes while outdoors.|
|Food||Carefully read all labels.Ask what the ingredients are when eating out.Avoid foods that may cross react such as bananas, kiwi fruit, and avocado.|
|Latex||Avoid all latex products. Ask if your hospital has latex safety issues if you need to be hospitalized.|
Since avoidance is not fail-safe, a person at risk for an anaphylactic reaction must be adequately prepared in an emergency to handle a reaction. It is recommended that everyone at risk carry epinephrine injection kits designed for self-administration. These kits are available by prescription only and come in two forms:
EpiPen is a spring-loaded automatic syringe that delivers a predetermined dose (0.3 mg) when the tip is pressed hard for several seconds. An EpiPen junior is available for children under 33 pounds and contains half of the dose.
Ana-kit contains a preloaded syringe and needles with two 0.3 mg doses of epinephrine. These are injected under the skin or into the muscle of the thigh. An antihistamine, alcohol swab, and a tourniquet are included in the kit.
Epinephrine auto-injectors may be the right choice but check with your doctor. While having an epinephrine auto-injector is important, it does not prevent a reaction from occurring. Remaining vigilant is critical. Epinephrine/epinephrine auto-injector is considered to be the first-line treatment of choice. Seek immediate emergency medical treatment after use.
Here are some places where YOU may want to consider having an epinephrine auto-injector available:
|Work, School or OfficeBack pack, purse or gym bagOn business or vacation
What to do in an emergency
If you’re with someone who is having an allergic reaction and shows signs of shock caused by anaphylaxis, act fast. Signs and symptoms of shock caused by anaphylaxis include pale, cool and clammy skin, weak and rapid pulse, trouble breathing, confusion, and loss of consciousness. Even if you’re not sure symptoms are caused by anaphylaxis, take the following steps immediately:
- Call 911 or emergency medical help.
- Get the person in a comfortable position and elevate his or her legs.
- Check the person’s pulse and breathing and, if necessary, administer CPR or other first-aid measures.
- Give medications to treat an allergy attack, such as an epinephrine auto injector or antihistamines, if the person has them.
Using an auto injector
Many people at risk of anaphylaxis carry an auto injector. This device is a combined syringe and concealed needle that injects a single dose of medication when pressed against your thigh. Always be sure to replace epinephrine before its expiration date, or it may not work properly.
Be sure you know how to use the auto injector. Also, make sure the people closest to you know how to administer the drug — if they’re with you during an anaphylactic emergency, one of them could save your life. Medical personnel called in to respond to a severe anaphylactic reaction also may give you an epinephrine injection or another medication to treat your symptoms. If you want to learn how to use an Epi Pen please contact me for training.
If you have a history of serious allergic reaction, always have an epinephrine kit available; it could save your life.
Information from WebMd, Mayo Clinic, Medic First Aid, ARC and NM Dept of Health
Today’s post comes to us courtesy of Ken Oswald, Safety and Security Manager for Plateau