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    First Aid for Serious Allergies

    Dr. Mary Williams, RN, DC

    About the author

    Dr. Mary Williams, RN, DC

    Dr. Mary Williams, R.N., D.C is a Doctor of Chiropractic with an extensive background as a Registered Nurse and experienced Core Instructor for the American Heart Association. She has over 30 years of hands-on medical and instructional experience.

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    Your immune system protects your body from foreign bodies that could make you sick. It does this by making antibodies, which are specialized cells designed to seek out and destroy anything foreign in blood and tissue that it deems a threat.

    When it’s working perfectly, this system is very effective. However, some people’s immune systems are a little too sensitive. They can identify common foods—such as milk, peanuts, gluten, or shellfish—or very mild irritants, such as bee venom—as dire threats. When that happens, the immune system can respond by overreacting and attacking healthy cells in the body.

    For those with only mild sensitivity, it can cause irritating symptoms—such as red, itchy skin, rashes and hives, sneezing, digestive issues, or watery eyes. For those with more severe allergies, it can cause anaphylactic shock—a serious condition that can result in respiratory failure, cardiac arrest, and death.

    For people with allergies this serious, avoiding common food ingredients such as peanuts or wheat can be a matter of life and death. But it can be hard to avoid these things—especially since for some people, trace amounts of peanut dust, for example, that appears in food made in the same factory as other foods with peanut ingredients can cause an allergic reaction.

    If you have someone in your family with severe allergen sensitivities—or you’re near someone who has a serious reaction—here’s what you should do.

    First, know when it’s an allergic reaction. Mild symptoms of allergic reactions include skin rashes and hives, swelling, diarrhea and other digestive problems, or respiratory issues such as congestion, sneezing, or a runny nose. Anaphylactic shock doesn’t look like this. It may manifest first as a feeling of nausea or lightheadedness, and the patient may have a weak pulse. The patient may also have difficulty breathing, as the airway can swell. When left untreated, people suffering from anaphylactic shock may lose consciousness before suffering respiratory failure or cardiac arrest.

    Treatment for Serious Allergies

    Administer epinephrine yourself. Some people with serious allergies know that they have them—and for very serious afflictions, they may carry an EpiPen with them at all times.

    An EpiPen is an autoinjector that contains a single dose of epinephrine that can be injected into the thigh. You don’t need to have advanced medical training to use it. Here’s a basic step-by-step for most EpiPens:

    • 1. Take off the blue safety cap.
    • 2. Press the orange tip against the outer thigh until you hear a click.
    • 3. Hold the pen in place for ten seconds.
    • 4. Take the pen off and massage the site of injection for another ten seconds.

    That’s it; the EpiPen will automatically inject the medicine into the victim’s thigh. An EpiPen can inject through clothing if needed. Some children with severe food allergies may need to carry two EpiPen's. This is in case a second dose is needed to treat an allergic reaction. Be sure to alert a qualified medical professional first before administering a second EpiPen shot. Due to recent price increases in EpiPen autoinjectors, some people may be carrying an alternative called Adrenaclick. This device administers the same medicine as an EpiPen. The key difference is that the Adrenaclick has two caps to remove as opposed to EpiPen's one cap. Be sure to read the instructions fully on either devices before administering.

    Call 911 for a more serious reaction. If you believe someone near you is suffering from anaphylactic shock, call 911. Do this first if the person doesn’t have an EpiPen.

    Perform CPR. If the person suffering the allergic reaction does not have an EpiPen and loses consciousness, you may have to perform CPR. Place the heel of your hand just between the nipples at the center of the chest, and then place your second hand over your first. Positioning your body so that your shoulders are above your hands, press down hard and fast using your body weight as well as the strength in your arms. The speed should be around the beat of “Stayin’ Alive” by the Bee Gees. Keep doing it until you tire and someone else can take over, or until medical personnel arrive.

    If the person is awake, treat for shock. Keep them lying down, and keep them warm. Raise their feet about a 12 inches over their head. Talk to the person to keep them calm. Do not try to give them oral medications, especially if they are having trouble breathing.

    Treatment for Mild Allergic Reactions

    If it’s mild, an allergic reaction can easily be treated by over-the-counter decongestants and antihistamines, usually available as eye drops, tablets, or nasal sprays. Cortosteroid creams can help swelling or itching skin.

    Poison ivy and other irritating plants. Poison ivy, poison sumac, and poison oak are extremely common allergens, and it’s not unusual for people to develop reactions—especially those living in more rural areas.

    If you are exposed to one of these, avoid scratching the exposed area—this will just spread the irritation around and result in a bigger rash. Take a shower under cool water, and use colloidal oatmeal products or calamine lotion to soothe the swelling. While over-the-counter cortosteriod creams may provide relief, many may be too weak for the intense poison ivy rash; your doctor can prescribe you a stronger cream if necessary.

    Insect stings. Insect stings usually cause a minor allergic reaction, particularly around the sting site. First, try to take the stinger out of the skin using a pocket knife or credit card, or another object with a straight, slightly sharp edge. Try to avoid squeezing or pulling the stinger out, as this could just drive the stinger further in and spread more venom at the sting site.

    Once the stinger is out, wash the area with soapy water. If there is swelling, apply ice. An over-the-counter acetaminophen will help reduce any pain. Administer 1-2 benadyl allergy tablets, chewables, or liquid if the allergic reaction gets worse or the person is known to have allergic reaction to bee stings. Always call 911 and get medical assistance if the reaction appears to be severe.

    Jellyfish. Some jellyfish stings can be extremely serious; others less so. Less-serious jellyfish stings can still be painful, however, causing itchiness, a stinging sensation, and swollen skin. Luckily, washing the exposed area with vinegar or even seawater for 30 minutes can neutralize the jellyfish toxins.  Use ice to reduce swelling, and apply a topical hydrocortisone cream if needed. Over-the-counter antihistamines can also help.

    Allergies can be mild and irritating—or they can be life-threatening. Mild allergies can usually be treated using ice, over-the-counter antihistamines, and topical cortisone creams.

    However, more serious allergies can be major medical emergencies. If you know someone near you has a serious allergic condition, ask them to show you how to use their EpiPen—so if you’re ever in a situation where they need  the help, you’ll be prepared. If you take these measures, hopefully you should be able to keep the person as safe as possible until help arrives.



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