Anaphylaxis is a severe life-threatening condition that occurs as a result of an allergic reaction to some allergens, such as food, bee sting, and venom. These foods mainly involve peanuts and tree nuts. It can happen within seconds or minutes of exposure to these toxic allergens that you are allergic to.

Anaphylaxis makes your immune system produce a large number of chemicals that can result in an anaphylactic shock. Your blood pressure suddenly goes down, and your lungs become narrow, causing breathing problems.

Anaphylaxis develops a series of signs and symptoms, which include skin rashes, nausea, rapid weak pulse, and vomiting. All these symptoms cause a person to develop shock.

Treatment of anaphylaxis requires a rapid injection of adrenaline and a follow-up plan with certain medications. If left untreated, it can be proven fatal.

Some people are vulnerable to an anaphylactic shock, such as those who have a previous history of shock, asthma, and those who smoke a lot. Its proper diagnosis and accurate management are essential to prevent complications.

Symptoms of Anaphylaxis

Symptoms of anaphylaxis usually develop suddenly after you interact with an allergen. In some cases, they may take half an hour to build up. Signs and symptoms include

• Nausea
• Vomiting
• Anxiety
• Abdominal pain
• Skin rashes
• Airway inflammation
• Rapid feeble pulse
• Confusion
• Coughing
• Facial swelling
• Fainting or dizziness
• Hypotension (low blood pressure)
• Swollen throat
• Swallowing difficulty
• Shock
• Skin itching

These symptoms can lead to loss of consciousness and eventually shock. Some people have biphasic anaphylaxis, which is the development of a second anaphylactic reaction after the first attack.

When to see a doctor? for Anaphylaxis

If you or any of your family members have an anaphylactic condition, seek medical help instantly. Do not wait even if your symptoms go away on their own.

If you carry an autoinjector of epinephrine, inject it immediately whenever you experience its attack. If symptoms of anaphylaxis go away after you inject the epinephrine, you must go to the emergency room for further management.

The accurate diagnosis and management of anaphylaxis shock are difficult, so you need to see your doctor regularly.

Causes of Anaphylaxis

Your body produces antibodies continuously to defend itself against harmful toxins, such as bacteria or viruses. This mechanism is helpful when foreign substances are lethal. But, in anaphylaxis, the immune system of some people overreacts to substances that are not harmful.

Symptoms of anaphylaxis are not so severe, but these mild symptoms can lead to severe anaphylactic shock. If you have mild symptoms in the past, then you are prone to develop more severe signs during the second attack.

Children get this disease mostly from food allergies. Other causes are peanuts, tree nuts, exercise, latex, and milk.

Anaphylactic triggers in adults include:

• Certain medicines, such as common pain killers and aspirin
• Ants, bee stings, and wasps
• Crustacean shellfish
• Soybeans
• Wheat

Less commonly mild aerobic exercises, such as jogging and walking can cause an anaphylactic reaction. Some people can also develop this condition when they eat before exercise or when they do exercise in humid weather.

Talk to your doctor about preventive measures that you should take in anaphylaxis. If you don’t know the cause of your anaphylaxis, ask your doctor for certain tests that can identify that allergen.

Idiopathic anaphylaxis:

In this type of anaphylaxis, the cause is unknown.

Risk factors of Anaphylaxis

However, not many of these factors are known, but you should avoid certain risk factors.

• Asthma or other allergies: people who have an asthmatic condition or allergy are at a greater risk of developing anaphylaxis.

• Previous history of anaphylaxis: people who previously suffered from anaphylaxis are at a higher risk. This condition will be more severe the second time than the first time.

• Other diseases: certain other diseases, such as heart problems or mastocytosis can make you vulnerable to anaphylaxis.

First aid for Anaphylaxis

Anyone who has anaphylaxis needs therapeutic care urgently.

First aid for anaphylaxis involves the following steps.

• First of all, remove that allergen from the body and call the emergency helpline
• Make the patient cool and loosen his or her clothing
• If the person feels faint, help him sit
• Ask the person if he has a previous history of anaphylaxis
• If he has any urgent medications, such as an adrenaline injector, then help him inject it
• Spend some time with him
• Make sure that he will get emergency help urgently

Doctors recommend that an allergic person must carry two injectors of epinephrine with him all the time.

How to use an autoinjector?

If people get confused and want the medications, first calm them down, and ensure that you are with them. Affected people should free both of their hands to get an injection of adrenaline.

Following steps are required during the usage of EpiPen.

• Take the pen from him or her
• Hold the pen in one fist with the orange colored end pointing down
• Now hold the injector in the upright position and remove its blue safety release with your other hand
• Now swing the hand carrying the injector to somewhat lateral and inject it at the lateral side of the thigh
• Carefully listen to the clicking sound of needle release from the orange end
• After injecting the device, hold it for almost 3 seconds

After removal of the device, its orange part will cover the needle. Unfortunately, if the needle is not covered, then do not readminister it.

Never use your thumb to remove the blue safety release, always use both hands to prepare the EpiPen.

If you remove the blue safety release in the wrong way, you can waste its adrenaline material by releasing it too early. In this way, you would make the person suffer more.

There are different types of adrenaline injectors. Although types of injectors are different, their mechanism is same.

Breathing support

If the emergency help is delay, help him breathe if he is having a breathing problem. Help him lie down if he feels faint.

If the person has difficulty breathing, help him breathe by performing cardiopulmonary resuscitation (CPR). Continue the CPR until health care professionals arrive.

Spend some time there until the doctors or health care workers arrived. When emergency help arrives, you let them know that,

• What was the reacting allergen
• Which medications he received earlier

Try to avoid that allergen while ensuring him to the hospital.

Complications of Anaphylaxis

An anaphylactic reaction can be complicated and can lead to an anaphylactic shock. It can also cause breathing problems by blocking the airway. It gets block by inflammation of the airway due to that allergen.

It can rarely cause a heart attack. All these complications are fatal.

Preventions of Anaphylaxis

If you have experienced anaphylaxis before or you have been allergic to some substances, then try to avoid them to prevent future episodes. The safest way to check imminent episodes of anaphylaxis is to avoid allergic substances.

• Always keep an emergency kit along with you: always carry an epinephrine auto-injector with you. Do not forget to check its expiry date. Refill it upon its expiration.

• Make sure to tell every doctor about your allergic conditions: every time you go to your doctor for any query, do not forget to tell him about your allergic situations. Also, tell your doctor which medications you have had.

• Avoid allergic insects: if you are allergic to certain insects, such as bees, try to avoid them. Wear proper clothes with long sleeves, do not walk on the grass barefooted, do not use scents, and do not drink from an unhygienic environment. Also, avoid killing insects by hand.

• Wear a bracelet: Wear a specific colored bracelet to alert people, if you get any allergic symptoms. You can talk to your doctor about the bracelet or necklace.

• Carefully read the labels on food packets: if you have an allergy to certain foods, read the ingredients carefully that are labeled on the food packet.

• Identify your allergic stimulus: if you could not identity your allergic trigger, go to the clinic and ask for blood tests that can recognize.

• Always check for the expiry date of the auto-injector

If you have any family history of anaphylaxis, it is important to tell your friends, family members, and staff about the allergic conditions.

Positioning during anaphylaxis

People who have anaphylaxis should be put in comfortable positions.

• Many people should rest flat

• Pregnancy: Pregnant women should lie on their left side to prevent putting pressure on the large vein that carries blood to the heart.

• Breathing problems: people with breathing difficulty should sit to ease their breathing.

• Unconsciousness: unconscious people should be placed in a position, which is favorable for them to open the airway.

• Avoid sudden standing up: Do not let him stand up abruptly after an anaphylaxis attack. It can cause a shock-like fall in blood pressure.

If a person stops breathing, do CPR as soon as possible.

Diagnosis of Anaphylaxis

Your doctor will ask you about your family history, causative agents, and symptoms. He will also ask you about previous allergic symptoms and their severity.

You`ll be most probably develop these symptoms if you have anaphylaxis:

• Confusion
• Throat swelling
• Nausea and vomiting
• Lightheadedness
• Hypotension
• Cyanotic skin
• Rapid feeble pulse
• Face swelling
• Hives

To confirm the diagnosis,

• Your doctor might perform some blood tests to find out the allergen or trigger of the allergy

• Blood tests show elevation of tryptase enzyme, which is elevated after 3 hours of an anaphylactic reaction.

• Your doctor uses a stethoscope to listen to crackling sounds during breathing. These crackling sounds indicate fluid in the lungs.

Many diseases have symptoms that are similar to anaphylaxis. Your doctor will perform some extra tests to rule out these conditions.

Treatment of Anaphylaxis

In anaphylaxis, you might get medications, resuscitation therapy, and epinephrine injection.

You might get CPR if your heart stops beating. Your health care provider might prescribe you some medications.

• Oxygen: oxygen is inhaled if you have breathing difficulty

• Adrenaline: adrenaline injection is administered suddenly after an anaphylactic attack.

• Beta-agonists: A short-acting beta-agonist, such as albuterol is given orally to relieve breathing problems

• Intravenously administered cortisone and antihistamines: these drugs are given to improve breathing by reducing the inflammation in the lungs

What to do in an emergency?

If your son, friend, or any family member experiences anaphylaxis in front of you, behave fast to relieve the symptoms as soon as possible. Note his or her pale yellow skin, rapid feeble pulse, breathing difficulty, and loss of awareness.

Act on the following steps:

• Call any emergency medical help
• Inject epinephrine in the thigh by autoinjector
• Let the person lie down and help him raise his legs
• Do not forget to check the pulse and breathing of the person. If he has any breathing problems, do CPR.
• Tell the health care provider about the allergic trigger of anaphylaxis
• Make sure the removal of the allergic agent before the patient go to the hospital

Epinephrine

Epinephrine helps in many steps:

• It narrows the blood vessels to increase the blood pressure.
• It relaxes the muscles that cover the lungs
• Epinephrine blocks the release of histamine from the cells

Epinephrine relieves the symptoms almost in 10-15 minutes. If symptoms do not go away, administer another dose after 10 minutes of the previous injection.

Sometimes the symptoms of anaphylaxis return. The patient should be hospitalized for the next 24 hours.

If the allergic reactions are less critical, a doctor may administer corticosteroids or antihistamines.

Long term management

If your allergic reaction is triggered by the sting of an insect, your doctor may give you a series of allergic chemicals to reduce your response to that allergen. This procedure reduces the sensitivity of your body’s immune system. This method reduces the recurrence of future episodes.

Unfortunately, if you have any immune system disease, then you cannot take these allergy shots. You can`t take these medications if you have a disease that has weakened your immune system. You can take the following steps to prevent future episodes:

• Avoid your allergic triggers as much as you can.

• Always carry adrenaline with you. You can inject it by yourself with the help of an autoinjector.

• Wear an emergency bracelet or necklace.