❤️‍🩹First Aid Unit 11 – Allergic Reactions and Anaphylaxis

What Are Allergies and Anaphylaxis?

• Allergies occur when the immune system overreacts to a normally harmless substance (allergen)
• Allergic reactions can range from mild symptoms (itching, rash) to severe, life-threatening reactions (anaphylaxis)
• Anaphylaxis is a serious, potentially fatal allergic reaction that affects multiple body systems
  • Can cause difficulty breathing, throat swelling, and a sudden drop in blood pressure
• Allergies develop when the body produces antibodies called Immunoglobulin E (IgE) in response to an allergen
• Subsequent exposure to the allergen triggers the release of chemicals like histamine, causing allergic symptoms
• Allergies can be triggered by various substances, including foods, medications, insect stings, and latex
• Anaphylaxis requires immediate medical attention and can progress rapidly, leading to shock and unconsciousness

Common Allergens and Triggers

• Food allergens are among the most common triggers, with peanuts, tree nuts, shellfish, and milk being major culprits
• Insect stings from bees, wasps, and hornets can cause severe allergic reactions in some individuals
• Medications such as penicillin, aspirin, and certain anesthetics may trigger allergies
  • Reactions can occur even if the person has safely used the medication before
• Latex found in gloves, balloons, and other products can cause allergic reactions, especially in healthcare workers
• Environmental allergens like pollen, dust mites, and animal dander can trigger allergic rhinitis (hay fever) and asthma symptoms
• Exercise-induced anaphylaxis may occur during or after physical activity, sometimes in combination with food allergens
• Idiopathic anaphylaxis has no identifiable cause, making it challenging to diagnose and manage

Signs and Symptoms to Watch For

• Mild allergic reactions may cause itching, rash, hives, or mild swelling (lips, face, eyes)
• More severe reactions can lead to throat tightness, difficulty swallowing, and hoarseness
• Respiratory symptoms include shortness of breath, wheezing, coughing, and nasal congestion
• Anaphylaxis may cause abdominal pain, nausea, vomiting, and diarrhea
  • These symptoms can be mistaken for other conditions, delaying proper treatment
• Cardiovascular signs of anaphylaxis include dizziness, fainting, rapid heartbeat, and low blood pressure
• A sense of impending doom or anxiety can accompany severe allergic reactions
• Symptoms can develop within seconds to minutes of exposure and may progress rapidly

Assessing the Severity of an Allergic Reaction

• Quickly determine if the reaction is mild or potentially life-threatening
• Ask the person about their allergy history and any previous severe reactions
• Look for signs of respiratory distress, such as wheezing, gasping, or difficulty speaking
• Check for signs of shock, including pale or clammy skin, weak pulse, and confusion
• Monitor the person's level of consciousness and responsiveness
  • Deteriorating mental status is a red flag for anaphylaxis
• If multiple body systems are affected or symptoms are rapidly worsening, treat as anaphylaxis
• When in doubt, err on the side of caution and activate emergency medical services

First Aid Steps for Mild Allergic Reactions

• Remove the person from the allergen source if possible (e.g., move away from a bee or wasp)
• Administer an oral antihistamine, such as diphenhydramine (Benadryl), if available and not contraindicated
• Apply a cold compress to the affected area to reduce swelling and itching
• Monitor the person closely for any signs of symptom progression or difficulty breathing
• If symptoms worsen or do not improve with initial treatment, seek medical attention
• Advise the person to follow up with their healthcare provider for further evaluation and management
• Educate the person on avoiding future exposure to the allergen and always carrying emergency medication

Emergency Response for Anaphylaxis

• Call emergency medical services immediately and inform them that the person is experiencing anaphylaxis
• If the person carries an epinephrine auto-injector (EpiPen), assist them in using it or administer it for them
  • Inject the EpiPen into the outer thigh, holding it in place for at least 3 seconds
• Help the person lie down with their legs elevated to maintain blood flow to vital organs
• Loosen tight clothing and remove any constricting items (e.g., jewelry) to facilitate breathing
• If the person is unconscious and not breathing, begin CPR with rescue breaths
• If symptoms do not improve or worsen after 5-15 minutes, administer a second dose of epinephrine if available
• Stay with the person and monitor their condition until medical help arrives

Using an EpiPen and Other Treatments

• Epinephrine is the first-line treatment for anaphylaxis and should be administered as soon as possible
• EpiPens are designed for easy use by laypeople and come with instructions on the label
  • Remove the safety cap and firmly press the orange tip against the outer thigh until it clicks
• Hold the EpiPen in place for at least 3 seconds to ensure full dose delivery
• Massage the injection site for 10 seconds to enhance absorption and circulation
• Antihistamines and bronchodilators (inhalers) can be used as adjunctive treatments but should not replace epinephrine
• Corticosteroids may be administered by medical professionals to prevent delayed or biphasic reactions
• People with a history of anaphylaxis should always carry two epinephrine auto-injectors and wear medical alert jewelry

Prevention and Long-term Management

• Identifying and avoiding allergen triggers is crucial for preventing allergic reactions
• People with food allergies should carefully read labels and inform restaurants of their allergies when dining out
• Those with insect sting allergies should take precautions when outdoors, such as wearing protective clothing and carrying epinephrine
• Immunotherapy (allergy shots) can help desensitize the immune system to specific allergens over time
  • This treatment is typically administered under the guidance of an allergist
• Regularly visit an allergist to develop and update an allergy action plan
• Always carry emergency medications, including epinephrine auto-injectors and antihistamines
• Educate family, friends, and coworkers about your allergies and how to respond in an emergency
• Consider wearing medical alert jewelry to inform others of your allergies in case you are unable to communicate