Overview

If you are allergic to a particular substance, your immune system overreacts to the allergen through the release of chemicals that can cause allergy symptoms. Usually, these symptoms occur in one area or location of the body. However, some individuals are more susceptible to a severe anaphylactic reaction. The reaction usually affects more than one body part at the same time.

Anaphylaxis causes the immune system to flood the body with chemicals that can cause you going into shock – your blood pressure could drop suddenly, and your airways could narrow and block breathing. Signs and symptoms of an anaphylactic reaction include a skin rash, weak but rapid pulse, vomiting, and nausea. 

Anaphylaxis needs immediate medical care, such as an injection of epinephrine and a trip to the nearest emergency room of a hospital. Anaphylaxis can become fatal when not properly treated.

Specific individuals are at a higher risk of anaphylaxis. The risk of anaphylaxis is higher in individuals who have asthma, allergies, or a family history of anaphylaxis. If you experience anaphylaxis, you will be at a higher risk of having another anaphylactic reaction.

Allergies should be diagnosed accurately and successfully managed. An allergist or immunologist can diagnose your problem and help you draw up a protection plan against allergies.

Causes

A person’s immune system produces antibodies as a defense against foreign substances. This is beneficial when the international content is harmful, such as viruses or certain bacteria. But some individual’s immune systems may overact to materials that do not usually cause an allergic reaction.

Allergy symptoms generally are not life-threatening, but an allergic reaction, when severe, may lead to anaphylaxis. An individual or a child who has had a mild anaphylactic reaction in the past could be at a higher risk of more severe anaphylaxis when exposed to another allergy-causing substance.

The most common triggers of anaphylaxis in children are food allergies, such as fish, milk, shellfish, peanuts, and tree nuts. Anaphylaxis triggers in adults include fish, nuts, shellfish, peanuts, and any of the following:

• Stings from bees, wasps, yellow jackets, fire ants, and hornets
• Latex
• Certain medications, such as aspirin, antibiotics, and other over-the-counter pain medications, and the intravenous contrast used for some imaging tests

While not very common, some individuals develop anaphylaxis from aerobic exercises, such as jogging, including some less intense physical activity, such as walking. Eating certain foods before exercising when the weather is hot, humid, or cold has been pinpointed as the trigger to anaphylaxis to some people. Seek your doctor’s advice before applying.

If you do not know the exact cause of your allergy attack, your doctor can order specific tests to help identify the allergen. There are some cases when the cause of anaphylaxis is never identified, referred to as idiopathic anaphylaxis.

Symptoms of anaphylaxis

The symptoms of anaphylaxis usually occur within a few minutes of exposure to an allergen. At times, it may happen a half-hour or longer after exposure. The signs and symptoms of anaphylaxis include:

• Low blood pressure
• Skin reactions, such as itching, hives, and flushed or pale skin
• A rapid but weak pulse
• Constriction of the airways and swelling of the tongue or throat, which can cause trouble breathing and wheezing
• Vomiting, nausea, or diarrhea
• Fainting or dizziness

Complications of anaphylaxis

An anaphylactic reaction can be life-threatening. It can stop your heartbeat or breathing.

Diagnosis and Treatment

Your doctor will ask you questions about your previous allergic reactions, including if you have reacted to:

• Medications
• Particular foods
• Insect stings
• Latex

The doctor might do any of the following to help him confirm the diagnosis:

• Order a blood test to measure the amount of tryptase, a particular enzyme, that usually is elevated for up to three hours after an anaphylaxis
• Ask that you are tested for allergies with skin tests or blood tests to help determine the trigger.

Many conditions could have signs and symptoms that are similar to those of anaphylaxis. Your doctor should rule out other conditions.

Treatment

During an anaphylactic attack, you will receive cardiopulmonary resuscitation or CPR if you stop breathing or when your heart stops breathing. You might also be administered medications, including:

• Epinephrine, adrenaline, to reduce your body’s allergic response
• Oxygen, to help you breathe easily
• Intravenous cortisone and antihistamines to reduce the inflammation of the air passages so your breathing could improve
• A beta-agonist like albuterol to relieve your breathing symptoms.

Things to do in an emergency

If you are with an individual who is having an allergic reaction and begins showing signs of shock, you need to act fast. Start looking for refreshing, pale, and clammy skin; a rapid but weak pulse; confusion, trouble breathing; and loss of consciousness. Immediately do the following:

• Call emergency medical help by dialing 911.
• If available, immediately use an epinephrine autoinjector by pressing it into the person’s thigh.
• Make sure the person is lying down with his or her legs elevated.
• Check the person’s breathing and pulse, if necessary, administer CPR or other first-aid measures.

Using an autoinjector

Most people who are at risk of anaphylaxis typically carry an autoinjector. The device is a combination of a syringe and a concealed needle for injecting a single dose of medication when pressed against the thigh. The autoinjector must always be replaced before its expiry date. Otherwise, it will not work correctly.

The immediate use of an autoinjector can keep anaphylaxis from getting worse and save your life in the process. Be sure to know how to use an autoinjector properly. Also, make sure that the people who are close to you should know how to use it.

Long-term treatment

If insect stings trigger your anaphylactic reaction, a series of allergy shots will have a high chance of reducing your body’s allergic response and prevent a severe reaction in the future.

In most cases, however, there is no way of treating the underlying immune system condition that can lead to anaphylaxis. But you can take steps to prevent future attacks. 

You should be prepared if another one occurs.

• As much as possible, avoid your allergy triggers.
• Always carry wherever you go, self-administered epinephrine. You can give yourself the drug, using an autoinjector, during an anaphylactic attack.

Coping and support

It is always frightening to have a potentially life-threatening reaction, whether it happens to you or another person close to you. Preparing an emergency action plan for an anaphylactic attack will help you have peace of mind.

Work with your doctor or your child’s doctor in developing a written, step-by-step plan of the things you should do in the event of a reaction. Share your project with your family, teachers, caregivers, and babysitters.

If your child has a severe allergic reaction or has had anaphylaxis, talk to the school nurse and teachers to determine if they have any plans for dealing with an emergency. Make sure the school officials have a current autoinjector.

Prevention

Anaphylaxis is a life-threatening emergency. People with allergies are the most susceptible to it. However, it cannot always be predicted. Some people may react to a substance that has not affected them previously.

After having an allergic reaction, the person must remember what caused it, and to avoid it in the future.

It is not always possible to avoid an allergen, so they may need to carry with them an autoinjector and wear a bracelet that will let other people know that they have an allergy. People should make their family, friends, employers, and school staff know about any allergies they have that could cause a severe reaction.

Anaphylaxis is a potentially life-threatening emergency that requires immediate assistance. Everyone must know the signs and symptoms and how to react.

Risks of Having Anaphylaxis

There are very few known risk factors for anaphylaxis, but some things that could increase your risk include:

• Allergies or asthma – People who have either allergies or asthma are at a higher risk of having anaphylaxis.
• Previous anaphylaxis – If you have had anaphylaxis once, you are at high risk of having an increased severe reaction. Future reactions might be more severe than the first one.
• Certain other conditions – These include heart diseases and the abnormal accumulation of a specific type of white blood cell – mastocytosis.

When to Seek Medical Attention

If you believe you have an anaphylactic reaction, immediately use your epinephrine autoinjector. After injecting yourself, directly call 911 or emergency medical services so you can be brought to the nearest emergency department for further evaluation, monitoring, and additional treatment by healthcare professionals. Your life depends on your prompt actions. Do not take an antihistamine or wait to see if your symptoms will get better. If your symptoms get worse, you may no longer be in the position to take further actions, such as calling emergency medical services. Do not take chances by waiting it out.

If you have an allergic reaction to anything, it is always a good idea to consult a doctor. The doctor can help you identify the allergen that triggered your allergic reaction. Knowing your allergen will help you avoid it in the future.

Table of Medications

• EpiPen
• epinephrine
• EpiPen 2-Pak
• Phenergan
• promethazine
• Adrenalin
• Auvi-Q
• Phenadoz
• Promethegan
• Antinaus 50