Anaphylaxis: Causes, Symptoms, Treatment, and Prevention
Analysis
22 Year In Review : "The New Normal" that Wasn't
Table of contents
Causes of Anaphylaxis
The immune system, the body’s natural defence against disease and infection, is the cause of anaphylaxis. When you have anaphylaxis, your immune system overreacts to an innocuous substance and releases various substances to combat the imagined threat, including histamine.
Triggers of Anaphylaxis
Some of the typical anaphylactic triggers are:
- Insect Stings
Anaphylaxis can be brought on by any insect bite or sting, although wasp and bee stings account for most instances. One in 100 persons is thought to experience an allergic reaction after being stung by a wasp or bee; however, only a small percentage of these people experience severe anaphylaxis.
- Food
Peanuts are the culprit in more than half of all occurrences of food-related anaphylaxis. Other foods that have been linked to anaphylaxis include:
- Nuts
- Milk
- Fish and shellfish
- Eggs
- Fruit
- Medicines
The following medications are known to cause anaphylaxis in a limited number of people:
- Antibiotics, particularly those that are penicillin-like,
- General anaesthetics, which are muscle relaxants used during surgery, and
- Nonsteroidal anti-inflammatory medications (NSAIDs), which include ibuprofen and aspirin, are types of painkillers.
Even though they may have previously taken these medications without experiencing any adverse effects, people who are susceptible to them typically have anaphylaxis as soon as they start a course of treatment.
These medications carry a very low risk of causing anaphylaxis; therefore, in most cases, treatment advantages outweigh the potential risk. For instance, the likelihood of experiencing anaphylaxis is about:
- 1 in 1,480 – after NSAID type painkiller
- 1 in 5,000 – after penicillin
- 1 in 10,000 – after general anaesthesia
- Contrast Agents
Contrast agents are a class of special dyes used in some medical exams to enhance the visibility of specific body parts on scans like X-rays. For instance, an X-ray of a blood vessel after a contrast agent injection will help identify any issues with the vessel, such as a blockage. Angiography is the term for this. According to estimates, the likelihood of experiencing anaphylaxis following a contrast agent injection is less than 1 in 10,000.
- Rubber Latex
Less than 1 in 100 members of the population are allergic to natural rubber latex. Workers in the healthcare, hair, beauty, catering and automotive industries are more likely to be allergic to latex. The likelihood of being impacted is higher in people with hay fever, asthma, eczema, and certain medical disorders, including spina bifida.
- Idiopathic Anaphylaxis
Even after rigorous investigation, anaphylaxis can occasionally occur for no apparent reason. This is known as Idiopathic anaphylaxis.
Symptoms of Anaphylaxis
- swelling of the mouth, tongue, or throat, which can make breathing and swallowing difficult
- itchy skin or a raised
- a lightheaded or faint feeling
- swollen eyes, lips, hands, and feet
- breathing difficulty
- stomach pain
- red skin rash
- nausea
- losing consciousness
Treatment for Anaphylaxis
1. Adrenaline Injections
Your blood pressure increases, and your swelling decreases due to the narrowing of the blood vessels brought on by adrenaline. Additionally, it facilitates breathing by opening the airways. As soon as a significant reaction is detected, adrenaline should be administered.
The individual experiencing anaphylaxis can administer the injection; however, there are situations when someone else may be required, such as if the patient is a young kid or unconscious. Make sure you understand the procedure before performing the injection. When the injector is first prescribed for you or the person you are in charge of, you should carefully read all the instructions. The syringe must be held still for five to ten seconds after injection. Through clothing, one can administer injections.
Even if the person is beginning to feel better after receiving the adrenaline injection, you should still call 999 immediately to get an ambulance. Most patients should see a quick improvement in their symptoms after using the adrenaline. If there isn’t any improvement after 5 to 10 minutes, you should, if possible, provide a second dosage of adrenaline. This needs to be injected into the thigh on the other side.
2. Positioning and resuscitation
To help maintain blood flow to the head and heart, the person should lie flat with their legs raised. Pregnant women should lie on their left side to prevent too much pressure on the large vein leading to the heart. Sitting up will help with breathing if the person is conscious but experiencing problems breathing.
Check the person’s breathing and ensure their airways are open if unconscious. After that, position them in the recovery posture to prevent them from choking on their vomit. Make sure the person is supported by one arm and one leg as you turn them onto their side. Tilt the head and elevate the chin to widen the airway. Cardiopulmonary resuscitation (CPR) should be carried out if the person’s breathing or heart stops beating.
3. Admission to Hospital
Even if adrenaline is administered, the patient will still require hospitalisation for observation, typically lasting 6 to 12 hours. This is because symptoms occasionally come back during this time. An oxygen mask can aid breathing in the hospital, and intravenous fluids infused directly into a vein can help raise blood pressure. In addition to adrenaline, other drugs like antihistamines and corticosteroids can be used to treat symptoms.
While in the hospital, blood tests may be performed to confirm anaphylaxis. You should be free to leave the hospital when the symptoms are under control and anticipate that they won’t recur immediately. If the symptoms are severe, you should stay in the hospital for a few days, even though this could happen within a few hours. Two to three days after leaving the hospital, you might be instructed to take antihistamines and corticosteroid medications to help prevent the recurrence of your symptoms. You’ll probably be asked to make a follow-up appointment so that you can receive guidance on how to prevent additional anaphylactic reactions. You might be given an adrenaline auto-injector to use in case of an emergency between the time you leave the hospital and the follow-up visit.
Prevention for Anaphylaxis
Advice and medication should be given to you if you have anaphylaxis to help you avoid further attacks.
1. Allergy Clinic
To perform testing and determine what triggered the anaphylaxis, you need to go to a specialised allergy clinic. You can prevent further anaphylactic reactions by knowing what allergen causes the allergic reaction.
Among the procedures frequently used to identify allergies are:
- A skin prick test involves pricking a small amount of a potential allergen into your skin to determine if your skin reacts by turning red, elevated, and itchy.
- A blood test is performed on you to determine how your blood will respond to a potential allergy.
2. Adrenaline Auto-injectors
If you’ve already experienced anaphylaxis and there is a chance that you will have it again in the future, you can be given a prescription for an adrenaline auto-injector.
Three distinct auto-injector kinds exist:
- EpiPen
- Jext
- Emerade
You should ensure you understand how to use your auto-injector because each model differs somewhat. Additionally, you can request a “trainer” kit to practise injecting yourself or your child.
3. Avoid Triggers
If a trigger has been determined to be the source of your anaphylactic reaction, you must take precautions to avoid it.
- Food
The likelihood of being in contact with a food allergy can be decreased by:
- looking at food labels
- Letting a restaurant’s employees know what you’re allergic to so it won’t be present in your food
- Some foods may include minute amounts of allergens; for instance, some sauces contain wheat and peanuts.
- Insect Stings
By adopting simple precautions, such as the following, you can lessen your risk of being stung by an insect:
- Avoid swatting at wasps, hornets, or bees by slowly backing away from them without panicking.
- If you spend time outside, especially in summer, apply an insect repellent.
If you are at a particularly high risk of receiving another stung, such as if you work as a beekeeper or gardener, certain specialised allergy clinics also offer unique treatments to help desensitise you to insect stings.
- Medicines
There are usually safe alternatives if you have an allergy to a particular class of medication. For example, if you have an allergy to
- Penicillin – Normally, taking a separate class of antibiotics known as macrolides is safe.
- Non-steroidal anti-inflammatory drugs (NSAIDs) – Paracetamol is often safe to consume. Still, you should carefully review the contents of products like cold medications to be sure they don’t contain NSAIDs.
- One type of general anaesthetic – There are alternatives available, and it might even be possible to perform surgery under a local anaesthetic or epidural injection.
- Angiotensin-converting enzyme (ACE) inhibitors – Calcium channel blockers can be utilised as an alternative blood pressure treatment.
- Contrast Agents
The use of contrast agents might be required in some circumstances, such as when there is internal bleeding in the brain, even if this increases your risk of allergy.
In some cases, antihistamines and corticosteroids can be injected into you before the contrast agents, which may assist prevent symptoms from happening or, at the very least, lessen their severity.
Our First Aid at Work training course describes the causes, symptoms and treatment for anaphylaxis in detail. You will also learn how to spot an emergency, and how to assist a person after an allergy.
