Allergy emergency – would you know what to do?
This week’s edition of ‘Trust me, I’m a doctor’ on BBC1 focused on the most severe of allergic reactions, life-threatening anaphylactic reaction. When I was a medical student, I don’t remember seeing a single patient with anaphylaxis– they were out there somewhere but they were definitely a rarity. These days, I regularly get letters from the allergy clinic about patients newly diagnosed with severe allergies. They always include comprehensive plans of what to do in case of minor reactions (antihistamines) or if anaphylaxis is suspected (first aid, adrenaline (epinephrine) injection on the spot if possible, call 999/112/911 for an ambulance).
The number of people affected by anaphylaxis has increased six-fold in the last two decades in the UK. The USA has seen a similar rise, with almost 1 in 50 Americans affected. While the most common culprit is peanuts, other leading causes include shellfish, fish, treenuts, eggs, milk, fruits and food additives.
Anaphylaxis affects your whole body – symptoms come on with frightening speed, and include swelling of the tongue, throat and lips; an itchy pale pink rash; sudden hoarseness, wheezing and shortness of breath; tummy pain, nausea and vomiting; palpitations and collapse. Untreated, it can be fatal, and time is of the essence where treatment is concerned. That’s why everyone with a history of anaphylaxis should carry an adrenaline (epinephrine) injection, which they can administer for themselves if possible – and their nearest and dearest should all be trained in how to recognise the symptoms and how to give the injection to them if they’ve already collapsed.
There is some promising research out there looking at possible treatments, even to peanut-related allergy. But there is no magic bullet on the horizon yet, and urgent treatment will be needed for the foreseeable future.
According to a recent American study, just over 54% of life-threatening anaphylactic reactions happen at home , yet 60% of sufferers didn’t have a life-saving adrenaline (epinephrine) auto-injector to hand when it happened. A recent UK survey (ref 1) showed that:
- Nearly eight in ten people (78%) who know someone with an adrenaline (epinephrine) auto-injector think they know how to administer it correctly. In fact, just a quarter would inject it into the right place if the need arose
- Less than half of people (43%) who carry an adrenaline (epinephrine) auto-injector would know to inject themselves immediately in the event of anaphylactic shock
- Less than half of the general public (49%) know that adrenaline (epinephrine) auto-injectors can – and should – be injected through clothes if necessary
- More than half of the general public (53%) don’t think they would recognise if someone was going into anaphylactic shock
Watching someone collapse in front of your eyes and being unable to help is a deeply traumatic experience. Yet using a lifesaving adrenaline (epinephrine) auto-injection device isn’t difficult. There are several different types available, but Allergy UK has step-by-step guides on how to use all of them. Maybe learning how could be one New Year’s resolution you actually keep.
1) Bausch and Lomb survey involving 1,002 people, UK data, October 2015