Understanding Anaphylaxis

As allergies increase, more kids are heading to school armed with epinephrine auto injectors. It’s their best defense against anaphylaxis—a potentially life-threatening allergic reaction.

Anaphylaxis can affect both kids and adults and is becoming a bigger concern than ever given the uptick in allergies to food and other environmental triggers in recent years. In this article, we’ll discuss what anaphylaxis is and how it can be avoided—or treated if it does develop.

Understanding Anaphylaxis

(Pixabay / Myriams-Fotos)

What causes anaphylaxis?

Anaphylaxis occurs when your immune system overreacts to a stimulus. The most common stimuli include:

  • Peanuts
  • Tree nuts
  • Fish/shellfish
  • Bee stings
  • Fire ant bites
  • Latex
  • Medication, to include antibiotics, penicillin, aspirin, non-steroidal anti-inflammatory drugs (such as Advil and Aleve), and IV contrast drugs

None of these stimuli is inherently dangerous, but your immune system thinks they are. In response, your body declares “war” on them, releasing chemicals into the body that cause serious—even fatal—reactions.

What are the symptoms of anaphylaxis?

The severity and symptoms of anaphylaxis vary, but they may include:

  • Skin rash, such as itchy hives
  • Change in skin tone (may become pale or flushed)
  • Swollen tongue
  • Swollen airways, which can cause difficulty breathing
  • Drop in blood pressure
  • Quickened pulse
  • Nausea
  • Vomiting or diarrhea
  • Dizziness
  • Fainting

What are the risk factors for anaphylaxis?

If you have an allergic reaction to food, you may be at risk for anaphylaxis. Even if your reaction was mild, it could become more severe with increased exposure to the food. The same goes for insect bites or medicine.

If you have asthma or another respiratory disease, your airways are more likely to become constricted during an anaphylactic reaction. Also, if you have had an anaphylactic reaction, you are at greater risk of having one again, and future reactions may be more severe.

How can you reduce your risk for a serious anaphylactic reaction?

  • Avoid risk factors. The obvious answer is to avoid the things that trigger your allergies. If you know that you are allergic to nuts, for example, read labels carefully before eating packaged foods. If you’re eating out, make sure to tell your waiter or waitress about your allergies. They can help you know if nuts may be used in certain dishes or if surfaces and cooking utensils have been used for different food preparations, resulting in cross-contamination.
  • Talk to a doctor. If you have any of the risk factors described earlier in this article, consult an allergy physician. They can prescribe epinephrine that can be administered through an auto-injectable device. You may have heard of an EpiPen. That is a brand name of a popular type of these devices.
    The epinephrine helps reverse the allergic response throughout the whole body by inhibiting the release of the chemicals that cause the allergic reaction to intensify further. It can restrict the blood vessels so that sagging blood pressure will climb back up to normal levels. It can also decrease swelling and open up the airways.
  • Learn to use your epinephrine auto-injector. It’s critical that your doctor shows you how and when to administer the epinephrine. You don’t want to freeze up when the medicine is needed—a quick reaction can make the difference between life and death. Epinephrine is generally recommended for any severe symptoms or for mild symptoms occurring in more than one of the body’s systems.
  • Keep two injectors with you. If your doctor has prescribed an epinephrine auto injector, you should keep it with you at all times. In fact, you should keep two of these injectors with you. Even if you are smart about avoiding trigger foods, you never know what foods have been cross-contaminated in the cooking or manufacturing processes. Given that anaphylactic reactions can be fatal, it’s best to play it safe at all times.
  • Educate helpers. If you’re an adult with severe allergies, you can educate your friends, partner, or older children about when and how to administer epinephrine. Food Allergy Research & Education has a great form for guiding people through the epinephrine administration process.
    If you have a child with allergies, it’s critical that you educate the teachers and other staff members at their school or daycare about their allergy needs. Ensure that they have easy access to your child’s auto-injector and a back-up injector at all times. This can usually be accomplished in a meeting with school leadership, the school nurse, the teacher, and the food services director at the school (if your child has food allergies).
    If your child has insect allergies, make sure to alert and educate the people who will be outside with them at recess.

How can you help someone who is experiencing anaphylaxis?

Watch for the symptoms described earlier in this article. If you suspect anaphylaxis, follow these steps:

  • Administer epinephrine (if available).
  • Call 9-1-1 or alert someone else to make the call.
  • If the reaction occurred due to an insect sting, remove the stinger using something flat and firm (like a credit card). Press the card against the skin beneath the stinger and slide it upward to try to dislodge the stinger.
  • Lay the person flat, elevate their legs, and make sure that they are warm.
  • If they are vomiting or having trouble breathing, skip the lay flat part and have them lay on their side or sit up.
  • Administer CPR if the person stops breathing.
  • Get them to the hospital—even if they seem to be recovering. There’s always a risk that the reaction could return so they should be checked out by a physician.

Will I ever be rid of these allergies?

Some people outgrow allergies to food, medications, and insect stings or bites. Other allergies persist into adulthood. Though there’s not much you can do to change medication or insect sting/bite allergies, there are now food allergy treatment programs that can reduce reactions to food proteins. Talk to your doctor about sublingual immunotherapy for food allergies.

Anaphylaxis is frightening—both for the victims and the people around them who witness the reaction. While some reactions can’t be avoided, others can be prevented or mitigated with careful preparation and vigilance.

About The Author

Stuart H. Agren, M.D.

Stuart H. Agren, M.D. completed his undergraduate studies at the University of Utah and went on to earn his Doctor of Medicine from Tulane University School of Medicine in 1974. He completed additional training at L.D.S. Hospital in Salt Lake City, Utah and then established his private medical practice starting in 1975. Dr. Agren completed a mini-residency in Industrial Medicine at the Robert Johnson School of Medicine at Rutgers University and also completed training to become a certified Medical Review Officer.

Dr. Agren was the Medical Director at TRW and McDonnell Douglas in Mesa, Arizona and at Stauffer Chemical and Kennecott Copper in Salt Lake City, Utah. He also served as an adjunct faculty member at Arizona State University.

In his private medical practice, Dr. Agren specialized in family practice and allergy. In his work as a private practice allergist, he was one of the first doctors in the country to prescribe sublingual immunotherapy to his patients as an alternative to subcutaneous immunotherapy (allergy shots). He has also been a trailblazer in the field of food allergy treatment and research, developing a program to treat multiple food allergies simultaneously using sublingual immunotherapy. Dr. Agren has been featured on local CBS, NBC, and ABC news affiliates and won the peer-nominated “Top Doc” award from Phoenix Magazine.

After 20 years in private practice, Dr. Agren became the Founder and President of AllergyEasy, which helps primary care physicians around the country offer allergy testing and sublingual immunotherapy treatment to their patients. Over 200 physicians in over 32 states use the AllergyEasy program to help their patients overcome environmental and food allergies and asthma.