With more and more people receiving the COVID19 vaccine the word ‘anaphylaxis’ keeps cropping up in the news as people worry about having an allergic reaction to it. So here is some information from anaphylaxis.org.uk on what you need to know about allergic reactions. Theres a link at the end to the official COVID19 vaccine guidance on allergies answering the publics frequently asked questions.
Anaphylaxis is a severe and potentially life-threatening allergic reaction affecting more than one body system such as the airways, heart, circulation, gut and skin. Symptoms can start within seconds or minutes of exposure to the food or substance you are allergic to and usually will progress rapidly. On rare occasions there may be a delay in the onset of a few hours. It always requires an immediate emergency response.
The common causes of anaphylaxis include foods such as peanuts, tree nuts, milk, eggs, shellfish, fish, sesame seeds and kiwi fruit. Non-food causes include wasp or bee stings, natural latex (rubber), and certain drugs such as vaccines. Each year in the UK, approximately 500 people have severe allergic reactions to an anaesthetic drug, which translates to one in every 10,000 procedures. In some people exercise can trigger a severe reaction – either on its own or in combination with other factors such as a food.
Sometimes the cause of the reaction is not found. Such reactions may be labelled “idiopathic anaphylaxis” (cause unknown). This does not mean the condition is psychological, though emotional stress can sometimes worsen a reaction.
Most healthcare professionals consider an allergic reaction to be anaphylaxis when it involves a difficulty in breathing or affects the heart rhythm or blood pressure. Any one or more of the following symptoms may be present. These are often referred to as the ABC symptoms:
There may be a dramatic fall in blood pressure (anaphylactic shock). If that happens, the person may become faint and dizzy, or in the case of a child they may become floppy. This may lead to collapse, unconsciousness and – on rare occasions – death.
In addition to the ABC symptoms listed above, the following symptoms may occur:
Those symptoms can also occur on their own. In the absence of the more serious ABC symptoms listed above, the allergic reaction may be less severe but you should watch carefully in case ABC symptoms develop.
There are times when you may be particularly vulnerable and at increased risk of a severe reaction. Times when you need to be particularly careful to avoid the culprit allergen include:
• If you have asthma that is poorly controlled
• If you are suffering from an infection, or have recently had one
• If you exercise just before or just after contact with the allergen
• If you are also suffering from hay fever
• During times of emotional stress
• If you have been drinking alcohol
• If you have taken a ‘non-steroid anti-inflammatory drug’ (NSAID) such as aspirin or ibuprofen.
As soon as a severe reaction is suspected, an adrenaline injection MUST be administered.
The patient should remain as still as possible. Ideally lying down and if feeling weak, dizzy or pale and sweating their legs should be raised (see notes below).
Call 999. Say the person is suffering from anaphylaxis. Give clear and precise directions to the operator, including postcode.
Make a note of the time adrenaline was given. If there is no improvement, a second dose can be given after 5 minutes or straight away if the patient is suffering from an extreme allergic reaction.
If the patient deteriorates make a second call to 999.
Send someone outside to direct the ambulance crew.
Try to ascertain what food substance caused the reaction so you can tell the emergency services.
Pre-loaded auto-injectors containing adrenaline are prescribed for people believed to be at risk of anaphylaxis. Adrenaline is referred to in some countries as epinephrine, which is the internationally recognised term for adrenaline. See our tips on using an auto-injector.
The Medical and Health Care Products Regulatory Agency (MHRA) has provided advice on this. It states:
‘People who have been prescribed an adrenaline auto-injector because of the risk of anaphylaxis should carry two with them at all times for emergency, on-the-spot use. After every use of an adrenaline auto-injector, an ambulance should be called (even if symptoms are improving), the individual should lie down with their legs raised and, if at all possible, should not be left alone’
The most important thing to remember is that you should see urgent medical attention as soon as possible.
If you are working with children, vulnerable people with allergies or asthma, have a role as a carer or health professional, Child Matters offer classroom and online training on CPR, Basic Life Support techniques and Anaphylaxis including how to recognise an attack and how to use an auto-injector. CONTACT US if you’d like to book inhouse training for your team.
