Anaphylaxis Health Video

Video Transcript

JORDAN SHLAIN, MD: Anaphylaxis is an acute allergic response that the body has to something foreign that the immune system really doesn't like. It usually comes in the form of an insect bite, a medication, or a food allergy. The manifestations of anaphylaxis, which is really severe allergic reaction, an allergic reaction with a rash, maybe some hives, and maybe some nausea, but anaphylaxis is 80 plus percent of the time has a rash involved; it will have the pulmonary system involved so that you may have some wheezing and some stridor, which is a funny sound when you try to breathe, your lips may swell up; you could get a headache, it can involve the gastrointestinal system so you could have nausea and vomiting and diarrhea. That's all part of an anaphylactic response. It's mediated by the immunoglobulin E in the body which basically causes all of the blood vessels to dilate. When blood vessels dilate, fluid leaks out and then we start to see physical manifestations of swelling i.e. that your lips get really big, that's because all the blood vessels started to dilate there and they lost the contents of what was in the vessel to outside of the vessel, and when that swelling happens in the trachea or the larynx or the lungs, breathing becomes a significant problem. In addition to the blood vessel dilating causing leakage is the blood pressure falls. When the blood pressure falls, one can get lightheaded, they can faint. These are all life-threatening problems. The treatment for anaphylaxis is an epinephrine injection. There are consumer versions of a Twinject and EpiPen. Your doctor can write a prescription. You can put them in your travel bag or you keep one at home and they're really quite simple. You just open it up and it's kind of almost impossible to not do it right. You just take this little yellow rod and stick it in the lateral part of your thigh and then it will inject the right amount of epinephrine and that's an alpha agonist and a beta agonist and what that means is it will immediately constrict your blood vessels so they stop leaking. It will constrict your blood vessels so that your blood pressure goes back up and will also increase the rate of your heart so that you can get a decent blood pressure. When people's blood pressure start to fall, we need to get them immediately to the hospital. Most anaphylactic reactions do happen in the hospital because medications are given. And like I mentioned earlier, the three main causes are food, which can be peanuts, Brazil nuts, and other well-known food allergies. Medications are the most common reason for anaphylaxis and those are penicillins, macrolides, and erythromycins. Everybody usually knows what they're allergic to because they have had a bad reaction. And the third thing is insect bites and bee stings. Mosquito bites don't generally cause that but certain spider bites can cause an anaphylactic reaction. They usually start about 15 minutes after the insulting or the offending agent gets into your bloodstream and very quickly a patient can degenerate into a life-threatening crisis. So, what do we do if we're out in the field and we see anaphylaxis? The first thing to do is identify that it is anaphylaxis. It is not just an allergic reaction and you know that because they're relatively rapidly progressive. If somebody tales amoxicillin and gets a rash 6 hours later and just itches and it's bothersome and there's no other symptoms, that's an adverse or just a typical allergic reaction. In anaphylaxis, just 15 minutes and off to the race. People start to have all sorts of symptoms, whether it's breathing problem as I mentioned earlier, whether it's vomiting, diarrhea, severe headaches, fainting episodes, swelling of their lips. So those are the main reasons why it is important to identify and yet to call 911. It's not something you want to just watch and wait and see.