Anaphylaxis Reaction (Severe Allergic Reaction, beware of symptoms can occur at any time) - Medtick
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Anaphylaxis Reaction (Severe Allergic Reaction, beware of symptoms can occur at any time)

What is it?

A severe allergic reaction involving the antibody(IgE) which is involved in ones immune system.

  • The are other mechanism involved (non IgE related) involving Kinin [a group of substances formed in body tissue in response to injury. They are polypeptides and cause vasodilation (open up blood vessels) and smooth muscle contraction].

Anaphylaxis is likely when all three of the following criteria are met:

  1. There is sudden onset and rapid progression of symptoms;
  2. There are life-threatening airway and/or breathing and/or circulation problems;
  3. There are skin and/or mucosal changes (flushing, urticaria, angioedema)

Tse Y & Rylance G. Emergency management of anaphylaxis in children and young people: new guidance from the Resuscitation Council (UK). Arch Dis Child Educ Pract Ed 2009;94(4):97–101. doi: 10.1136/adc.2007.120378

 

Cause

The following sections discuss some of the common causes in more detail.

Table: Common causes of immunoglobulin E and non-immunoglobulin E-mediated anaphylaxis
Mechanism of allergic reaction*  Group Examples
IgE-mediated   Drugs, chemicals and biological agents Antivenoms, cephalosporins, chlorhexidine, ethylene oxide, formaldehyde, gamma globulin, insulin, muscle relaxants, penicillins, protamine, semen, sulphonamides, thiamine, vaccines
Foods Eggs, fish, flour, fruits, milk, peanuts, shellfish, tree nuts, vegetables
Venoms and insect saliva Ants, bees, hornets, jellyfish, scorpions, snakes, ticks, wasps
Other Horse dander, hydatid cyst rupture, latex, pollen
Non-IgE-mediated   Drugs and biological agents Angiotensin-converting enzyme inhibitors, aspirin, N-acetylcysteine, nonsteroidal anti-inflammatory drugs, opiates, radiocontrast media, vancomycin
Food additives Metabisulphite, tartrazine
Physical factors Cold, exercise, heat
*If a cause or trigger cannot be found, it is described as idiopathic anaphylaxis.
Source: Oxford University Press

 Warrell DA & Cox TM. Oxford Textbook of Medicine, fifth edn., Oxford: Oxford University Press; 2010. p. 3106–3114

Other risk factors include:

  • Age – children are more likely to experience food-related anaphylaxis, whereas adults are more likely to experience anaphylaxis owing to antibiotics, radiocontrast media, anaesthesia and insect stings. Children and older people are at an increased risk of severe anaphylaxis;
  • Gender – women have a higher risk of anaphylaxis owing to latex, aspirin, radiocontrast media and muscle relaxants, whereas men have a higher risk of anaphylaxis owing to insect venom;
  • Atopic history – an atopic background could be a risk factor for exercise-induced and latex-induced anaphylaxis, but not drug-induced anaphylaxis;
  • Comorbidities – people with asthma, cardiovascular disease, mastocytosis (abnormal accumulations of mast cells in the skin, bone marrow and internal organs) and substance misuse are at an increased risk of anaphylaxis
The Pharmaceutical Journal, PJ August 2020, Vol 305, No 7940;305(7940)::DOI:10.1211/PJ.2020.20208167

Symptoms

  • Neck swelling with wheezing (whistle noise while breathing) and/or breathing difficulties?
  • Swelling in eyes, mouth, lips and tongue?
  • Pain in chest?
  • Rapid heart rate?
  • Feeling hot and sweaty and yet skin feels cold and clammy (not always)?
  • Hypotension (low blood pressure), feeling faint, increased heart rate?
  • Loss of consciousness/slurred speech/uncoordinated?
  • Can’t swallow saliva, drooling?
  • Vomiting and diarrhoea?
  • Loss of sensation, can’t feel or numbness?
  • Wide spread rash and/or Blistering skin rash?
  • Swelling at parts of body?
  • Symptoms all over the body and widespread?

Complications /Information to beware of/General tips:

Medical emergency Condition

And/or do not wait, phone for an ambulance if have or develop:

This condition can be confused with:

Anaphylaxis Reaction

  • Use an adrenaline injection/pen immediately if suspected.
  • Never re-use, always use a new one.
  • if trousers are too tight and one has not got the right pen to use through clothes then use on arm as a last resort.
  • Please beware of the maximum doses of the adrenaline injections (unless advised by a medical healthcare professional otherwise):
    • Adults and children 12+  :  500mcg per dose
    • 6-12 years old:  300 mcg per dose
    • 6 months to 6 years old : maximum dose 150mcg
    • Birth to 6 months: 100mcg to maxiumum 150mcg
  • The purpose of the videos and images are to show only on how to use the adrenaline injection and not for any other purpose:

 

  • Emerade injection

    • Epipen injection

  • Jext injection (please use the injection once unless advised otherwise by a medical health professional).

If having breathing problems One should be encouraged to sit in an upright position to help both circulation and breathing.

Use your adrenaline injection (if available) as soon as possible.

 
If no breathing problems but show signs of Shock (low blood pressure):

 

Rapid hollow breathing

Cold, clammy skin (not always)

Rapid and weak pulse

Dizziness, faintness an weakness

Slow heart rate

 Encouraged to lie down and one raise their legs

This condition may have similar symptoms to:

Detailed Information

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