Anaphylaxis

Anaphylactic reactions are the most serious type of food allergy reaction.

This is the possibility of a life-threatening allergic reaction following eating food – especially, peanut, fish and sesame.

Although the fatalities with food allergy are extremely rare, nonetheless, they still do occur.
(I am unable to find a documented case of an egg allergy fatality).

Subsequently, it is important to know about this issue and to be prepared.

Anaphylaxis

Anaphylaxis is a severe, potentially fatal systemic allergic reaction that is rapid in onset.
Adrenaline (also called, epinephrine) is the first line medical therapy.  It needs to given promptly.
The most common way to give adrenaline at home is with an adrenaline auto-injecter:  “Epipen” or “AnaPen”.

The serious clinical presentations of anaphylaxis that are life threatening are:

  • Feel dizzy, confusion
  • Respiratory difficulty (wheezing and choking)
  • Cardiovascular collapse (pallor, sweating, shock).

To make a diagnosis of anaphylaxis, the following set of circumstances is required.

  • acute onset of symptoms involving the skin (hives, itchy, flushing) – but not always
  • respiratory system (breathlessness, wheeze, stridor)
  • or cardiovascular system (hypotonia, syncope) – a feeling of persistent dizziness.
  • also gastrointestinal symptoms may occur, including crampy abdominal pain and vomiting.

Recommendation

If you or your child has had a serious adverse food reaction, then you should have skin-prick tests and/or RAST/EAST tests to document the severity of this food allergy.  You should have an assessment as to if you warrant an EpiPen.

ACTION PLAN

Every one who has significant immediate food allergy should have an anaphylaxis “action plan”.

An individual health care plan for food allergy reactions.

  • Confirm allergens (by skin prick tests or RAST)
  • Assess medical risk
  • Especially if have asthma
  • Keeping child safe at school and on excursions

There is an increasing incidence of food allergies.

If you have a food allergy, we suggest that you have diagnostic tests (skin prick tests, or RAST tests) to document your allergies.
You need this information to manage your food allergy issues.

EPIPEN

“EpiPen” is the name for  an adrenalin auto-injector.
Injected adrenalin is the best emergency treatment of an anaphylactic reaction.
A quick effective easy way to give this emergency treatment is by using an EpiPen auto-injector.

Who needs an EpiPen?

You should be prescribed an EpiPen for food allergy if:
  • You have previously had a life-threatening anaphylaxis
  • You have “difficult to control” asthma and severe IgE food allergy.
  • You have allergy is to nuts or peanuts with a big skin-prick-test (15 mm or more)
  • You live a long way from emergency medical care
  • Your child weights more than 10 kg
With weight 10-20 kg, prescribe EpiPen Junior.
With weight over 20 kg, prescribe EpiPen.

Your EpiPen needs to be kept away from extreme temperatures and direct sunlight, to protect against drug degradation.

What to do after an EpiPen shot?

After adrenaline injection, you should seek emergency care promptly.

  • Call 111 in Australia and New Zealand.
  •  A second dose is required for anaphylaxis in up to 35% of cases. It may be repeated 5 to 20 minutes after the initial dose.
  • Watch out for possible transient adverse  tremor, anxiety, and palpitations associated with adrenalin injection.

Additional drugs

Other drugs that can be given are:

  • Antihistamines (can be given at the first signs of a reaction)
  • Brochodilators (salbutamol) for those with asthma
  • Steroids (take several hours to be effective)