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Anaphylaxis is the most severe form of an allergic reaction and has the potential to be life-threatening. Anaphylaxis occurs after exposure to an allergen such as food (eg nuts), herbal remedies, latex, insect stings (eg bees), or medicine, to which a person is already extremely sensitive.

It takes only 1 to 2 minutes for a mild allergic reaction to escalate to anaphylaxis. Some casualties may find that the symptoms they experience are always mild. For example, there may be a tingling or itching in the mouth and nothing more.

Anaphylaxis is a preventable and treatable event. The most important aspect of the management of casualties with life-threatening allergic reaction is avoidance of any known triggers such as:

• Food Most commonly nuts, sesame seeds, shellfish, cow milk, soy, egg and wheat.
• Herbal remedies Such as Royal Jelly.
• Insect stings Such as bees and wasps. The venom from these insects is different in each case, and therefore allergy to one does not increase the risk of reactions to another.
• Latex allergy Rare, but more common in some people frequently exposed to latex such as health care workers.
• Medication Particularly antibiotics and sometimes x-ray contrast dyes.

The most noticeable signs and symptoms are:

• hives
• swelling of the throat, lips, tongue, or around the eyes
• difficulty speaking, breathing or swallowing

Other common signs and symptoms may include:

• metallic taste in the mouth
• generalized warmth, flushing, itching, or redness of the skin
• chest discomfort
• abdominal cramps, nausea, vomiting, or diarrhoea
• increased heart rate
• sudden feeling of dizziness or weakness
• anxiety or a sense of doom
• collapse
• loss of consciousness

put on disposable gloves if available

• call ‘000’ for an ambulance
• reassurance
• adrenaline is the only drug that will act fast enough to rescue someone from a life-threatening reaction
• casualties who have a history of anaphylaxis are often prescribed self-administered adrenaline using an EpiPen®. If this is the case assist the casualty to self-administer their EpiPen® adrenaline* remove the injector from the packaging
  
  • remove the safety cap
  • swing the EpiPen® on to the injection area. There is no need to remove clothing
  • hold the EpiPen® (firmly) with the tip at right angles against the thigh (do not cover the end of the injector with your thumb!!)
  • press hard (there should be a click)
  • apply moderate (firm) pressure and hold for 10 seconds
  • remove and rub the area for 10 seconds
  • discard the unit safely
• observe for relapse as severe symptoms sometimes recur after apparent recovery

Useful Resource Australasian Society of Allergy and Clinical Immunology (ASCIA)
http://www.allergy.org.au