In individuals with severe allergies, a life-threatening reaction called anaphylaxis may occur after exposure to various allergens. This condition, which is a serious allergic reaction, can develop especially against poisons, foodstuffs and the active ingredient of various drugs. Most cases of anaphylaxis occur after bee stings or after individuals with various food allergies consume those substances.
What is Anaphylaxis?
Anaphylaxis is a common and life-threatening medical emergency characterized by the development of a hypersensitivity reaction. In general, the characteristics of anaphylaxis are rapid development, generalization, affecting many systems and being an allergic reaction. If appropriate treatment is not given, rapidly progressing anaphylaxis can cause the respiratory tract to close and reach life-threatening levels.
With the development of anaphylaxis, people may develop a skin rash, low pulse, and a state of shock defined as anaphylactic shock. If left untreated, anaphylactic shock is a fatal condition. Individuals diagnosed with this disorder are often recommended by healthcare professionals to carry epinephrine with them for early intervention. Thanks to this medicine, future reactions can be stopped before they become life-threatening.
What Causes Anaphylaxis?
Various drugs, foodstuffs and insect stings are the most common triggering factors of anaphylaxis. Peanuts, fish, shellfish and milk are among the foods that may cause anaphylaxis if consumed in individuals with allergies. Apart from these factors, latex exposure and exercise can also result in anaphylaxis in some people. It is recommended to be careful as anaphylaxis may occur in the body during immunotherapy applications used to relieve various allergic responses.
The body is constantly in contact with foreign substances. The immune system constantly synthesizes protein substances called antibodies against these living or non-living substances. In most cases, no different response occurs in the body with the release of antibodies. The development of anaphylaxis depends on the formation of an allergic reaction in the whole body due to the developing antibodies of the immune system.
What are the symptoms of anaphylaxis?
After encountering the allergenic substance, high amounts of a molecule called histamine are produced in the body. The histamine molecule generally triggers the development of an inflammatory response. Dilation of blood vessels, a sudden decrease in blood pressure, loss of consciousness or the development of a state of shock are among other problems that may occur due to the effect of histamine.
In an individual experiencing anaphylaxis, the airways are also quite narrow and the person may therefore have difficulty breathing. Fluid leakage from blood vessels causes edema to develop. This reaction may begin directly after contact with the allergen or may occur hours later. In some cases, the development of anaphylaxis after contact may take days.
Symptoms that occur in case of anaphylaxis may vary from person to person or depending on the type of allergy:
- runny nose
- Itching sensation in the throat and mouth
- growth of tongue
- difficulty swallowing
- Cough
- hoarseness
- Grunt
- Shortness of breath
- chest pain
- Abdominal pain or cramps
- Nausea, vomiting
- Diarrhea
- Development of skin edema, itching or rash
- extreme anxiety
- Development of edema in the hands, feet, lips, eyes or genital area
- A pale blue appearance of the skin due to low blood pressure
- Low pulse, dizziness
- Shock
- Loss of consciousness
Apart from these symptoms, other symptoms such as watery and red eyes, headache, metallic taste in the mouth or uterine cramping may also be added to the picture of anaphylaxis in some individuals. Care should be taken as situations such as severe breathing difficulties and sudden decrease in blood pressure can progress to shock and be fatal.
How is Anaphylaxis Treated?
Anyone experiencing a severe allergic reaction should seek medical attention immediately. Medical first aid for anaphylaxis can be summarized as follows:
- If an allergenic substance is detected, it should be removed from the environment to end exposure and seek support from emergency numbers.
- If people are prone to fainting, have them lean back or lie flat.
- If the patient is conscious, questioning whether he has experienced such a situation before or whether he is allergic to any substance.
- Ensuring the use of anti-allergy medications on them
- Staying with the person until emergency medical support arrives
Airway management is a very important issue in the treatment of anaphylaxis. Rough evaluation of the patient’s airway at the scene can be a warning about obstructions that may occur over time. Symptoms such as edema around or inside the mouth, hoarseness and angioedema are among the basic symptoms that indicate that changes may occur in the airway.
It is important because it may mean that the patient has experienced such a situation before and may be carrying an epinephrine injector, also known as adrenaline. Epinephrine is administered as an intramuscular injection and its dose varies between 0.3-0.5 mL for a concentration of 1:1,000. The dose used pediatrically (for children) is 0.01 mg per kilogram or directly 0.15 mg. Intramuscular administration is associated with faster distribution and better results than intravenous or subcutaneous (under the skin) administration of epinephrine. The thigh area is the muscle area most frequently used for this purpose.
Various studies show that the time before epinephrine treatment is quite long. Although only a single dose of injection is sufficient for many patients, if necessary, the dose of epinephrine can be repeated every 5-10 minutes until symptoms improve. With the injection of epinephrine, some changes occur in the person’s body. Among the main features of epinephrine are its ability to contract the vessels, relax the lungs, and prevent further chemical secretion in the body. Due to the possibility of shock developing after anaphylaxis, fluid and oxygen support may be given to people in healthcare institutions.
In addition to epinephrine, intravenous (intravenous) antihistamine or cortisone applications may also be beneficial for people who have airway problems. Drugs considered as beta agonists are among the agents that can make breathing easier.
If symptoms of anaphylaxis are observed in any individual in the environment, immediate medical assistance should be sought directly. People who have experienced this situation before and have an epinephrine injector with them should first apply this dose and then seek support from emergency hotlines. If you are helping someone in anaphylaxis, tell them that help will arrive soon and have the patient lie on their back, keep their legs off the ground, and cover them with a blanket if possible. It is recommended to avoid trying to give medication orally to people who have breathing problems. If breathing stops completely or the heart stops, CPR, called cardiopulmonary resuscitation, must be performed.
Anaphylaxis is a major medical emergency that can be life-threatening. Anyone experiencing this or a similar severe allergic reaction is advised to seek immediate medical attention. Knowing what to do in anaphylaxis and similar situations can result in saving your life and the life of those around you. It is especially important to be aware of the symptoms of anaphylaxis and to know how to act.
