Anaphylactic Shock: Symptoms, Triggers, Prevention and Treatments

The fields of Healthcare and Medicine in the 2010s have discovered and accepted that there is likely no substance at all on Earth that some human being will not react to allergically. The days of telling a patient, "No one can be allergic to ______ " are over.

As we come into contact with additional substances and materials through our Space Programs, we will likely find additional allergens.

Allergies can range in severity from mild to near-instant death and in a world of new technologies and new substances and materials created daily, we have more triggers that are potential allergens and potentially fatal.

Healthcare professionals need to listen to their patients as they describe reactions that are allergic. Health providers can no longer ignore symptoms and write prescriptions for drugs that cause allergies based on the belief that the patient is imagining things.

Parents, guardians, babysitters, and teachers need to listen to children if they describe or show allergic symptoms. Much of the public felt that chocolate and peanut allergies were hoaxes until the national news in the US presented increasing numbers of stories on childhood death from these allergies that resulted in anaphylactic shock.

In 2013, as several US States began to legalize medical marijuana, people who are allergic to substances in the in the plant began to speak out about their allergies to it. One physician in Toronto, Ontario, Canada, Dr. Gordon Sussman, who specializes in allergies and the immune system, began in 2011 to ask all of his patients whether they use marijuana or not so that he may treat them more fully. Some patients that require medical marijuana will need allergy treatment before using it.

OFFICE: 202 St Clair Ave W Toronto, ON M4V 1R2, Canada

PHONE: +1 416-944-8333

Clinical Trials Recruiting: SussmanAlergy

My first experience with anaphylactic shock occurred at age seven when my mother gave me a tablespoonful instead of a teaspoonful of codeine cough syrup.

At the time, parents in my community often used codeine cough syrup for their children at the first sign of a cold. Fortunately it was soon removed from drug store shelves and made available only by prescription. I had about one degree of fever, so I was given the codeine, with bad results.

My blood pressure plummeted, I had difficulty breathing, and I collapsed in a hallway as I was trying to walk. My mother let my lie there and when I revived some time later, she forced me to take more codeine, and the reaction repeated.

When I came to again, my fever was higher, so she attempted to give me more codeine and I began screaming in terror.

I ran to the refrigerator, even though I was never allowed to open it as a rule, grabbed a large bottle of Seven-Up and drank it all - I had dry mouth. Only screaming prevented another forced dose of codeine. When the family doctor finally heard about it all the next morning, He instructed my mother to keep codeine away from me, because I was allergic to it.

As an adult, I am allergic to codeine, morphine, ocycotin, oxycodone, Vicodin, Splenda (sucralose), and marijuana. Any of them can cause anaphylaxis for me, the reaction to marijuana being the worst (read about that here). Anaphylaxis can include a number of other symptoms in addition to those I suffer from codeine.

The most severe Anaphylactic Reaction is the most deadly allergic reaction that can result from exposure to an allergen.

Death can result very quickly in these cases and many stricken individuals have only a few seconds to use an EpiPen® for epinephrine (adrenalin) injection. Some need antihistamines as well, but taking Benedryl or giving it to your child before going somewhere that you suspect might contain allergens is not enough protection. In addition, the epinephrine must be taken after exposure, not before. It cannot be used as a "vaccination."

The strong influx of chemicals enters your bloodstream when an allergen comes into contact with your body and results in anaphylaxis. Some associated symptoms include the following list, but not everyone experiences them all at once or as severely as to cause death:

• Blood pressure drops suddenly
• Swollen tongue
• Airways narrow, blocking your breathing/closing your throat; sometimes breathing stops - administer CPR and call 911.
• Rapid, weak pulse
• Light headedness, dizziness, fainting
• Some patients experience vision narrowing, like blacking out parts of vision field
• Some patients hear ringing in their ears
• Skin rash or hives
• Feelking overheated
• Nausea and vomiting
• Cardiac arrest - needs CPR and a call to 911.

Notable Allergens that can cause Anaphylaxis:

• Latex - this is a particularly deadly allergen. Dr. Sussman reported anaphylaxis reactions, inhalant latex allergy, and occupational asthma as aspects lf LATEX ALLERGY. Before 1988, natural rubber latex allergy was thought to cause only contact allergic reactions. Some patients also died from allergy to latex tips on enema bulbs.
• Narcotics
• Penicillin
• Anethestics
• NSAID - Aspirin, ibuprofen, acetominaphen
• Naproxen (Aleve)
• Marijuana
• IV Contrast Dyes for tests
• Jimsen weed - Deadly in children. Volunteer tomatoes (those not planted, but which appear) sometimes cross with jimsen weed and should not be fed to children.
• A large number of foods that include chocolate, peanuts, nuts from trees, soy, wheat, fish, shellfish, milk, eggs, Splenda, MSG, food dyes (particularly all the reds, including red dye used on paper plates), and other lesser-seen allergens.
• Bee and wasp stings, fire ant bites, and similar
• Snake bite venom
• Exercise - Peoploe usually donlt think exercise can cause anaphylaxis, but it can cause exercise-related asthma as well.
• Sometimes an allergen is never found, but a person suffers anaphylaxis and needs long-term allergy treatment. This is idiopathic anaphylaxis, or a reaction limited to one person.

Never be afraid or hesitant to tell your doctor or your friends that you are allergic to something. Allergies are real and can be deadly. If you have anaphylactic reactions to a certain food, you cannot "eat it just once" at a someone's house for dinner and be safe from the reactions.

The best prevention is to avoid the allergens that cause anaphylaxis. However, children probably do not yet know all the things that may cause allergic reactions in their bodies. Parents, family, teachers, exercise instructors/coaches, babysitters, and daycare staff need to attend to children that complain of symptoms or show physical distress, especially respiratory distress or collapse.

Allergies can develop over time as well, even severe ones, and can be a surprise. Adults may find themselves allergic to items that previously caused them no discomfort. At the same time, some children outgrow some allergies.

The best advice is to be aware of allergy symptoms, including anaphylaxis, and to call 911 at once if you or someone in your vicinity collapses or begins having breathing problems that might signal an anaphylactic reaction, especailly one they have never had before.

If you call 911 in such a case, make sure the person lies down with feet elevated, with the body covered with a blanket or similar (tablecloth, coat, etc.). Be prepared to do CPR if breathing or heartbeat stops, if you know how to do it. Be reassuring. If the person suffering has an Epipen® and knows that this is anaphylaxis that calls for using the autoinjector, then they should use it. Help them find it. They will be grateful.

Animals also can have allergic reactions, even anaphylaxis, so if you see symptoms of a severe reaction in your dog or cat, do not hesitate to get help immediately from a veterinarian or animal emergency hospital.

TREATMENT BY MEDICAL PROFESSIONALS

• Epinephrine - Epipen® autoinjector (for self-injection into the thigh) or injection from paramedics or an ER professional. If you are allergic to bee stings, insect bites, and snake venoms, carry an autoinjector with you at all times in a small medical kit. Your child can keep one in the school office; but ensure that teachers and staff take allergies seriously.
• Oxygen via Mask - You may also need to be intubated, with an oxygen line placed down your airway, but not always.
• Intravenous (IV) Antihistamines
• Intravenous (IV) Cortisone - reduces swelling of airways and tongue.
• Beta-agonist (albuterol inhaler)* - helps with breathing.
• Evaluation by medical professionals and a long-term treatment and prevention plan.

*Side effects of albuterol (Ventolin inhaler or tablets) to recognize:

• Fine tremors - as in fingers
• Anxiety
• Headache, dizziness
• Muscle cramps
• Dry mouth
• Changes in heartbeat, including arrythmia
• Flushing of the skin, feelings of being overheated
• Changes in sleep and behaviors
• Allergic reactions - problems breathing, swelling, low blood pressure, collapse.

For specific questions about your own case or your child's allergies, call your doctor as soon as possible.

• Wear a medical alert tag. I keep a card with me that lists all of my allergies.
• Tell your doctor and pharmacist about all your allergies and all your medications and vitamin supplements when you go in for any treatment or prescription.
• Ask your doctor what to keep in a small emergency medical kit and keep it with you at all times.
• Stay away from stinging insects. In gardens, wear long sleeves and pant legs, closed shoes and socks, and a sun hat. do not use fragrances if you know you will be in a garden. Wear dull colors that do not attract insects. If you see an insect, walk slowly away.
• In the supermarket, read all the labels and look for your allergens. Then do not buy those products containing them.
• Be careful when eating in restaurants - ask about Splenda, soy, shellfish (especially shrimp broth used in cooking - it's more concentrated, cooked down shrimp shells) or whatever causes you a problem, before you order. Make sure you have your emergency medical kit with you. To be safest, know where the nearest hospital is located, but call 911 if you have severe reactions like anaphylaxis; do not try to go by car - there may not be enough time.

If you have questions about a specific case of allergies or possible allergies and how to diagnose and manage them, contact your doctor as soon as possible.