Food, Drug and Insect Allergies
If you have a severe allergic reaction, you may not be able to tell EMS providers about your condition. You may not be able to breathe, you may be too confused, or you may be unconscious by the time help arrives. Anyone with a moderate or severe allergy to food, drugs, or insects bites/venom should strongly consider obtaining a medical alert bracelet. Additionally, if you have a prescription for an EpiPen or similar device, you almost certainly should also have a medical alert bracelet that states you carry a EpiPen with you.
Anaphylaxis is a serious allergic (hypersensitivity) reaction that occurs rapidly and may cause death. Anaphylaxis has symptoms commonly associated with less severe allergic reactions, including: hives, itchiness, and flushing. It can also cause chest pain, cramping, abdominal pain and vomiting. However, the following three features of anaphylaxis are worrisome and can be life-threatening:
- Swollen lips, tongue, and uvula – Swollen tissue block the airway and prevent breathing
- Lung problems – Severe wheezing and stridor prevents oxygen from reaching the blood
- Low blood pressure – Blood flow to the brain is poor, causing dizziness, confusion, or loss of consciousness.
These symptoms can develop rapidly. You might not be able to communicate with bystanders or healthcare providers. Swollen lips and tongue can make it difficult to speak clearly. Wheezing can be so severe that your lungs cannot generate enough air pressure to create full sentences. Once confusion or unconsciousness occurs, communication is unreliable or impossible.
Emergency Anaphylaxis Treatment
If anaphylaxis is recognized in time, there are effective treatments. The best rapid treatment—one that is potentially lifesaving—is epinephrine injected into a muscle. Intramuscular epinephrine improves breathing and reverses low blood pressure. In short, it reverses some of the most dangerous symptoms of anaphylaxis. Epinephrine treatment is followed by intravenous fluids, antihistamines, steroids, and other measures to support blood pressure. If the airway is severely blocked, you might need to have a breathing tube placed in your lungs temporarily to hold the airway open.
If you have severe allergies your doctor may prescribed a device (e.g EpiPen) that can rapidly inject the right amount of epinephrine into a leg muscle in case you develop an allergic reaction. This way you or a bystander can administer treatment while waiting for paramedics to arrive.
In late March 2017, the makers of EpiPen announced that they were recalling the treatment because the mechanism could fail to deliver the drug. What is particularly frightening is that people with severe allergy may not be able to depend on the device in an emergency. Therefore, life-saving treatment falls to emergency medical services (EMS).
Paramedics and other EMS providers do not rely on EpiPens to deliver epinephrine. They can rapidly administer life-saving epinephrine using a needle and a syringe. However, they first need to know that you are having an allergy and are probably in anaphylaxis before they can administer the treatment. That is why a medical alert bracelet that indicates your allergy is critically important. If the EMS personnel can identify anaphylaxis, they can treat it. If they can’t, anaphylaxis may stop breathing and lower blood pressure to the point of death.