What should be done during an attack of anaphylaxis?

There’s no doubt an anaphylactic attack can be scary for the sufferer and those around him or her.  Most importantly, everyone should try to stay calm and do the following:

Administer epinephrine (using an epinephrine auto-injector) if it’s available.  This will help contract the blood vessels, relax the bronchial tubes and allow a return to normal breathing.  It can also stop symptoms like hives, itching and stomach cramps.

Call 911.  After using the epinephrine auto-injector, call 911.  Even if the person starts feeling better he or she should still be checked out by a medical professional.

Lie down and elevate the feet.

Consider giving a second epinephrine auto-injector injection after 5 minutes or more if symptoms have not improved or if they worsen again and medical professionals are not on the scene.

Be prepared for the possibility that IV fluids, oxygen and/or other medications such as antihistamines and steroids might be given by EMTs.

Once the danger has passed, make an appointment with an allergist if this is the first time an extreme allergic reaction has occurred.  The doctor will likely take a health history and want to know exactly what was going on (i.e., activities, foods eaten, any medications taken, any contact with rubber, etc.) before the reaction to try to pinpoint a cause.  Blood and/or skin tests may also be used to help find the trigger.

Good to Know

Inject the epinephrine into the upper outer thigh.

It’s okay to administer the epinephrine through light clothing.

What can cause anaphylaxis?

Extreme allergic reactions vary by individual.  Some common triggers include:

Foods (most often peanuts, tree nuts like cashews and walnuts, fish and shellfish, milk, soy and eggs)

Medications (while any medication can cause an extreme allergic reaction, antibiotics including penicillin are one of the most common; aspirin and ibuprofen are other possibilities)

Insect Stings (wasps, yellow jackets, hornets, honey bees, etc.)*

Latex Rubber (and/or other rubber products)

Good to Know

• Occasionally even exercise itself can bring on anaphylaxis—especially if a person has eaten a food he or she is sensitive to before working out.

What are the symptoms of an anaphylactic attack?

Just like symptoms can vary in severity, they can also differ in presentation.  Skin is most often affected with feelings of itching, tingling, warmth and/or hives.  Coughing, wheezing, difficulty breathing, swelling of the mouth and throat and other respiratory symptoms are also relatively common.

Gastrointestinal issues including cramping, vomiting and diarrhea can occur in anywhere from one-third to almost half of anaphylactic patients.  Very serious symptoms such as a drop in blood pressure, loss of consciousness and difficulty breathing are rare but need to be addressed immediately.  Don’t wait to see what happens—call 911.

Good to Know

Symptoms can begin immediately or up to several hours after the exposure.

Reactions can worsen over time and with repeated exposure.

Generally speaking, the faster the reaction happens the more severe it may be.

Some people can have a late phase reaction—both an immediate response to exposure and a second attack up to 2 to 24 hours later (without re-exposure).

Who is at risk for an anaphylactic attack?

Anyone can become a victim of anaphylaxis after they have been exposed once before to the allergen.  In other words, the first time a susceptible person eats peanuts or is stung by a stinging insect little or no reaction may result.  However, following the first exposure the body builds up a sensitization so that the next ingestion of peanuts or encounter with insect venom can result in a full-fledged anaphylactic attack.

Good to Know

People don’t always realize or remember they have had that initial exposure, so don’t automatically assume no reaction will occur.

Individuals who have had an anaphylactic reaction before are definitely at risk for another on the next exposure.  There’s no way to predict if it will be the same or more severe, so take it seriously and be on guard.