Just seconds after a bee sting, two-year-old Scott could barely breathe. One small bite of a dessert sprinkled with finely ground nuts sent Deborah, 26, into full cardiac arrest. Merely being on the same plane with a cat caused Stan, 28, to collapse with a drop in blood pressure and shock. Scott, Deborah, and Stan all experienced anaphylaxis, a life-threatening allergic reaction. Fortunately, proper emergency treatment and careful precautions can save such patients’ lives.
Anaphylaxis can be triggered by medications, chemicals, or exercise, as well as insect stings, foods, or animal dander. Symptoms include tissue swelling, hives, breathing difficulty, hoarseness, swelling of the throat, a drop in blood pressure, and shock. Prompt treatment with antihistamines, adrenalin, bronchodilators, oxygen, fluids, blood-pressure medication, and steroids is necessary to halt the reaction.
Anyone who has experienced an anaphylactic reaction must wear a medic alert tag or bracelet, and have on hand, at all times, an emergency kit containing a pre-loaded syringe of epinephrine (adrenalin) and the other necessary emergency medications.
Many emergency kits now contain an EpiPen, a preloaded syringe with a plastic end piece that resembles a pencil eraser. There is no exposed needle to cause anxiety. To administer the epinephrine, the patient pushes the tip of the “pen” against the skin. The needle pops out and delivers the proper epinephrine dose.
Insect Sting Reaction
Research suggests a serious sting reaction requiring medical care may occur in as many as one in 30 sting victims. However, with regular allergy shot treatments, 97 percent of patients with severe sting responses experience reduced reactions.
Hippocrates observed adverse reactions to milk in some of his patients more than 2,000 years ago. Today the U.S. Department of Agriculture estimates some 15 percent of the population may be allergic to a food or food ingredient.
Symptoms of true food allergy include generalized shock, hives, tissue swelling, rash, lip and tongue swelling, itching of the palate, wind-pipe swelling, vomiting, diarrhea, nasal congestion, eye tearing, breathing difficulty, and wheezing.
Allergy shots for foods aren’t available, so avoidance and emergency medications are the treatments of choice. To blunt possible reactions, allergic individuals may take a nonsedating antihistamine (preferably Hismanal or Seldane) before a meal. Sensitive individuals should always carry an emergency kit and ask questions about food ingredients.
Cat-induced asthma is well-recognized. Allergy shots using extracts of cat pelt, hair, or dander can help. But avoidance is most important. Cats should be banned from the bedroom and preferably kept outside the house. One recent study demonstrated that weekly baths can reduce the quantity of allergy-provoking proteins cats shed.
Allergic Reactions to Drugs
Allergic reactions to drugs may be life-threatening. They occur in two to three percent of hospitalized patients as well as in a large number of outpatients. Certain antibiotics, especially penicillin and its derivatives, are the most common triggers of allergic drug reactions. Fortunately, patients can be desensitized in the hospital if a drug is essential to treat an infection.
Allergy shots also have been associated with life-threatening reactions. The most severe reactions usually occur within the first few minutes. That’s why doctors require patients to wait 20 to 30 minutes in the office after receiving allergy shots. Delayed reactions can occur, but are rare.
Recently, life-threatening reactions have been reported to the latex in gloves used during medical procedures. Special non-latex gloves, all cotton drapes and robes, and other non-latex materials are available for use with sensitive individuals.
Exercise-induced anaphylaxis, which is unrelated to exercise-induced asthma, is a rare condition. Episodes are generally unpredictable and not associated with a given level or type of exercise. People who have experienced a severe allergic reaction associated with exercise needn’t give up physical activity, but they should always exercise with a buddy and carry adrenaline and antihistamines.
Allergic emergencies are often dramatic and frightening, and must be taken seriously. Avoidance and immunotherapy, together with medic alert tags and emergency medications, are essential.