Anaphylaxis

Anaphylaxis is the term given to a specific severe type of allergic reaction. Anaphylaxis is life threatening and can prove to be fatal. The allergic reaction occurs when the body becomes exposed to or absorbs or imbibes a substance containing the allergy-causing substance or chemical. When a person reacts and anaphylaxis occurs, this anaphylactic reaction may involve anaphylactic shock. The reaction can happen instantaneously and needs to be treated immediately. The reaction may be localized on one area or over the entire body. Anaphylaxis is a medical emergency. The emergency number 911 needs to be called without delay. An urgent trip to an emergency hospital clinic is indicated. A person who has allergies or who has had an anaphylactic reaction must be seen by an allergy specialist or immunologist to ensure adequate care and health management and to avoid high potential risk of anaphylaxis.

Background

An allergen is a substance causing an allergic reaction through the release of a chemical. The immune system of a person with an allergy perceives the allergen as a dangerous body. An antibody is created to fight off the foreign body, and an allergic reaction ensues. One part of the body, or the whole body, may react to the allergen.

An allergic reaction causing anaphylaxis can occur through a number of means. A bee or wasp sting may induce a reaction of this nature, as can the bite from an insect. A sting from an insect is usually a more common cause of anaphylaxis than a bite. Eating, touching, or being exposed to peanuts or other nut substances can cause anaphylactic shock to a person allergic to these products. Even a trace of the product may set off a severe episode. A range of foods are off limits to people who react to the allergens within them. In addition to nuts, these often include eggs, fish or shellfish, certain meat, milk, soy products, wheat, and gluten. Latex can also be a highly allergenic product for sensitive people and can result in the same severe reaction of anaphylaxis.

While not exactly the same as anaphylaxis, there is a possibility of someone having an anaphylactic-like or anaphylactoid reaction to drugs or medically related products, including aspirin, ibuprofen and related or other medicines, and morphine. An allergy to penicillin is problematic and can cause such a reaction, as can drugs involved with anesthesia. X-ray dye can also be a trigger. Although the anaphylactoid occurrence does not derive from an immune system reaction as with anaphylaxis, the risk is the same. The person will display similar symptoms, and treatment needs to be administered accordingly as it would be with anaphylaxis. Allergies to pollen are unlikely to cause anaphylaxis.

Biphasic anaphylaxis is less common than regular, or monophasic, anaphylaxis, occurring in an estimated 10 to 20 percent of anaphylactic reactions. "Biphasic" simply means "two phases." Anaphylaxis usually sets in almost immediately; biphasic anaphylaxis is a recurrence of symptoms with no further exposure after a period of apparent recovery. The interval between first and second reaction may range from approximately one to seventy-two hours.

The reason for the anaphylactic reaction may be evident, or it may require investigation after the occurrence. Tests may be conducted to ascertain which allergen has caused the reaction. Having experienced one occurrence, there is an increased risk of anaphylaxis recurring.

Overview

The most common instances of anaphylaxis occur when a person has an allergy to certain foods, drugs, or insect bites or stings. In some instances, the cause of anaphylaxis may be unknown.

Anaphylaxis occurs within seconds or, at the most, minutes. The reaction is rapid. There is a wide range of possible symptoms, of which any number may occur simultaneously. Swelling of the face and eyes is common, as is swelling of the tongue, which may be severe enough that the person finds it difficult to breathe or swallow. The nasal passages may become congested, adding to the inability to take in air. Difficulty with breathing is particularly pertinent and often escalates. This may be connected with abnormal sounds when trying to breathe, as well as wheezing or coughing. The person may not be able to talk, or may struggle to emit sounds that are rasping or hoarse. There may be heart palpitations. Anaphylaxis can cause the person to become unconscious. Other reactions associated with anaphylaxis include abdominal pain, nausea and vomiting, and diarrhea. A feeling of being dizzy, light-headed, or disoriented may be experienced, as may slurred speech and presentations of anxiety. The body might feel very itchy and become red, and hives may appear.

Calling 911 without any delay is crucial at the outset. Calming the person, where possible, is helpful. An epinephrine injection should be given immediately for someone having an anaphylactic reaction. Clearing the airway may be necessary, and this may be done by a medical professional performing an endotracheal intubation. In the event of emergency surgery, this may include a tracheostomy, whereby a tube is inserted into the trachea or via a cricothyrotomy.

Anyone who is highly allergic to any of the allergens present in particular food substances, drugs, or insect bites and stings is at risk of anaphylaxis. This medical history is pertinent, and especially crucial, if anaphylaxis has been experienced at any previous time. The risk of it happening or recurring is immense, and adequate care is required. This involves carrying documentation or wearing an identifying medical bracelet or equivalent, and having an epinephrine injection (containing adrenaline) on one’s person. If the person has a caregiver, that carer should carry the epinephrine injection or other prescribed treatment and know how to administer it. This also specifically applies to the parents of young children. Prescribed medical treatment such as injectable epinephrine must not be shared or used on another person other than the one for whom it is prescribed. Each person’s medical history is unique, and attempting to treat without having the appropriate information may result in causing harm rather than saving a life.

In an extreme situation, anaphylactic shock can create a complete closing of the air passages, resulting in a lack of oxygen intake. This may lead to respiratory arrest, in which the person in anaphylactic shock is no longer able to breathe. Cardiac arrest may occur. It is essential to call 911 as soon as anaphylaxis is suspected. Each second is crucial.

Bibliography

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