Many people experience allergy symptoms which are only a minor annoyance, broadly as described in the mild systemic reaction. However, a small number of highly allergic individuals are susceptible to a life-threatening allergic reaction known as anaphylaxis.
Anaphylaxis, the most serious type of allergic reaction, is extremely rare. Anaphylaxis symptoms as detailed in this website, usually appear rapidly – within seconds or minutes-after exposure to an insect sting. In a few cases, however, reactions have been delayed as much as 12 hours. Rapid diagnosis is important so that treatment, whether at hospital or on the way to hospital, can be effected.
Currently, the treatment of choice for anaphylaxis is an intramuscular injection of epinephrine, a hormone the body produces naturally in the adrenal glands. Epinephrine counteracts the symptoms of anaphylaxis but the down side is that its effects last only 10 to 20 minutes per injection, has some potentially serious side effects, and it must be administered correctly at or before the onset of symptoms to be effective.
Epinephrine, known to the layman as adrenaline, is most effective for treatment of anaphylaxis when injected into a muscle. Epinephrine works rapidly to make blood vessels contract, preventing them from leaking more fluid. It also relaxes airways, helping the individual breathe easier, relieves cramping in the gastrointestinal tract and stops itching and hives. Even if the individual responds to the epinephrine, it is vitally important to go to an emergency room immediately! Other treatments may be given such as oxygen, steriods, anti-histamines and medications to improve breathing. Intravenous fluids may be necessary to restore adequate blood pressure. Additional medications may be given to counteract the effects of histamine and to help prevent a delayed allergic reaction.
If the victim is stung, as they normally are, outside of a hospital, the importance of being able to easily administer adrenaline cannot be understated. Allergic individuals should always carry an auto-injector with them which enables the non-medical victim to easily self administer the life saving adrenaline. Many doctors recommend that two auto-injectors be carried due to the short term efficacy of adrenaline and the possibility that the auto-injector may not be administered correctly.
A product called Twinject comes automatically as a two shot product. The other three autoinectors most commonly used in the UK are Epipen, Emerade and Jext.
Do not wait until you get to hospital but self-administer the adrenaline in anticipation of the reaction getting worse. All auto-injectors – should deliver the same result and it is worth asking your prescribing doctor for you to try them both out. You may well favour one over the other.
Victims will find that the adrenaline often wears off after 10 to 15 minutes and so the symptoms may well deteriorate. If this is the case then another dose of adrenaline will normally cause no harm and once again can reduce the very real threat that anaphylaxis poses to the life of the victim.
It must be stressed that anaphylaxis is very life threatening and the most important thing is to get to hospital as quickly as possible.
Finally, anaphylaxis can be bi-phasic or delayed – it is possible that you can have a shock a few minutes after a sting, recover and then have another delayed reaction up to eight hours later. I would recommend that if you have had anaphylactic shock you should stay in the vicinity of an emergency room for at least four hours but ideally eight hours.