Allergic Reactions

Video 49 of 61
7 min 44 sec
English, Español
English, Español

While there are only around 1500 deaths each year in the U.S. from severe allergic reactions, it is nonetheless frightening how quickly these allergic reactions can occur.

Around 50 million Americans suffer from an allergy, and this is a number that's apparently on the rise. One theory as to why has to do with our too-sterile modern life. One that includes:

  • Antibacterial soap
  • Hand sanitizer
  • Air-tight homes
  • An increase in environmental pollutants

It seems our body's immune systems aren't developing as effectively to fight germs and other foreign invaders like they were in the past.

The most common causes of all allergic reactions are from foods (number one) and insects (number two). Children are most affected when it comes to food allergies. And while most kids outgrow their food allergies, according to the CDC, the number of children with food allergies rose by 18 percent in a 10-year span from 1997 to 2007.

Pro Tip #1: While most kids outgrow most food allergies, there is one that cannot be outgrown – the peanut. Sadly, peanut allergies are for life.

What Causes an Allergy?

The job of your immune system is to protect your body from foreign invaders – various bacteria, germs, and viruses. A healthy immune system protects the body even in the presence of these invaders.

However, when there is an allergy present, the immune system will mistakenly target and overreact to a threat that doesn't really exist. This results in your immune system attacking a harmless substance that has recently been eaten, inhaled, injected, or come into contact with the skin. And that substance is called an allergen.

An allergen can be introduced to the body a number of times with no trouble. Then, for seemingly no reason, the body one day decides to flag that allergen as a foreign invader, which triggers the body to attack the allergen. And to further complicate matters, the body will remember the allergen and produce specific antibodies that will attack the allergen even more fiercely next time it's introduced into the body.

Pro Tip #2: This is why allergic reactions are often more severe the second or third time – the build-up of antibodies and larger battles.

When the immune system attacks the allergen, high quantities of histamine and other chemicals are released into the surrounding tissues. Depending on the part of the body affected, symptoms can include:

  • Itching
  • Hives and rash
  • Sneezing
  • Wheezing
  • Swelling of the face
  • Runny nose
  • Nausea

There is one particular kind of allergic reaction that can be especially life-threatening – anaphylaxis.

Anaphylaxis is a severe and sudden allergic reaction that affects many parts of the body at the same time within mere minutes of the allergen coming into contact with the body.

Warning: Anaphylaxis can cause the body's blood vessels to suddenly dilate – as in opening all the way up, which can lead to anaphylactic shock. Anaphylactic shock can cause a sudden drop in blood pressure resulting in organs like the brain quickly becoming oxygen-starved. Anaphylactic shock will cause death if not treated.

One common and basic treatment for anaphylactic shock is epinephrine (or an epi-pen), as it constricts blood vessels and opens the airway, thereby reducing the effects of the allergen.

The most common causes of anaphylaxis are bees and other stinging insects, latex, medications and the following foods:

  • Nuts
  • Fish
  • Shellfish
  • Eggs
  • Milk

The most common cause of severe, life-threatening allergic reactions is by far the peanut.

How to Treat for Allergic Reactions

As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim.

"Hi, my name's _____. I'm a paramedic. I'm going to help you."

The first things you'll want to look for are the signs and symptoms of allergic reactions and anaphylactic shock:

  • Trouble breathing
  • Wheezing
  • Tightness in the throat
  • Itchiness on the tongue
  • Swelling of the face
  • Hives
  • Pale skin
  • Rapid heart rate
  • Low blood pressure
  • Nausea
  • Vomiting
  • Diarrhea
  • Dizziness

How children typically describe an allergic reaction may better help understand some of the signs:

  • It feels like there's hair on your tongue
  • You experience tingling
  • Your mouth itches
  • It feels like something is stuck in your throat
  • Your lips feel tight
  • Your body feels weird all over

Warning: The key element with allergic reactions is time. Don't wait. Call 911 immediately. If available, use an epi-pen. But don't wait for symptoms to get better.

The three steps to providing care for allergic reactions are:

  • Recognize the signs early
  • Call EMS or a code if in a healthcare setting
  • Assist the patient with an epi-pen if needed

Pro Tip #3: Keep the patient calm. Sit them down. Make sure they're comfortable. To make breathing easier, have the patient sit straight up and lean forward.

If the patient is feeling faint or is losing consciousness, lie them down, elevate their legs, and keep them warm. Talk to them, reassure them, but be prepared to begin CPR if they suddenly stop breathing or become completely unresponsive.

Warning: There is the possibility of a secondary reaction after the first. Which is why the patient should be monitored for four to six hours after the initial allergic reaction.

A Word About how to Know if it's Anaphylaxis?

Depending on the situation, there may be different things to watch out for as you put the puzzle pieces together. Here's a cheat sheet that may help.

Situation #1: You know that the patient has been exposed to an allergen.

What to Look For:

  • Trouble breathing OR
  • Signs and symptoms of shock

Situation #2: You think the patient may have been exposed to an allergen.

What to Look For: Any TWO of the following:

  • A skin reaction
  • Swelling of the face, neck, tongue, or lips
  • Trouble breathing
  • Signs and symptoms of shock
  • Nausea, vomiting, cramping, or diarrhea

Situation #3: You do not know if the patient has been exposed to an allergen.

What to Look For:

  • A skin reaction (such as hives, itchiness, or flushing) OR
  • Swelling of the face, neck, tongue, or lips PLUS
  • Trouble breathing OR
  • Signs and symptoms of shock