The principles of management of anaphylaxis
treatment are:
-Identify and avoid the cause (where possible)
-An Emergency Action Plan to treat accidental exposure
Since episodes of anaphylaxis are unpredictable, a well thought-out "Action Plan" is an essential part of management and should be practiced by the patient and care givers. It requires the patient and their care givers to recognize early warning symptoms, to carry appropriate medication and to be trained in its use.
Use of adrenaline (epinephrine) in anaphylaxis
The body's response to anaphylaxis is to release adrenaline,
a natural "antidote" to some of the chemicals released
as part of a severe allergic reaction. It can not be given by
mouth, and inhaled adrenalin is ineffective. Injected adrenalin
works rapidly to reduce throat swelling, open up the airways,
and maintain blood pressure. It is the only medication available
for the immediate treatment of severe allergic reactions.
Potential risks of giving adrenaline (epinephrine)
Common side effects are those of increased
heart rate, an increase in blood pressure, thumping of the heart,
shaking, nervousness or a transient headache. Of course needles
hurt, but you have to remember why you are using it!
Potential Risks of NOT giving adrenaline
(epinephrine)
Adrenaline is advised when you have
evidence of a potentially life-threatening allergic reaction,
such as inability to breathe or a drop in blood pressure. When
administered as directed, the risks of not giving adrenaline
far outweigh any potential side effects of the medication.
Storage of adrenaline (epinephrine)
Adrenaline may be stored at room temperature
and does not need to be refrigerated. As long as it is clear (and
not brown and cloudy), it is normally safe to use. The shelf life
of adrenalin is normally 1 or 2 years from the date of supply.
You need to check the expiry date from time to time. Automatic
injector devices like "Epipen" have a clear window near
the tip where you can inspect the drug.
Where to inject adrenaline (epinephrine)
The adrenaline is best injected into
the muscle of the mid thigh. Injecting here makes it extremely
unlikely that damage to any nerves or tendons will occur, or that
it will be inadvertently injected into an artery or vein, which
are deeply buried in the thigh. It is also the least painful part
of the body to give an injection!
Available adrenaline (epinephrine) preparations
in Australia
There are 3 commercial preparations
of adrenalin available. Your doctor will advise which is most
suitable for your needs, and the dose required.
EpiPen auto-injectors
The EpiPen autoinjector device was originally developed for military
use to administer antidotes to poison gas attacks. Each EpiPen
has only one dose of adrenaline. It is designed to be used as
a First Aid device by people without formal medical or nursing
training.
To view a pictorial guide to using EpiPen,
click HERE.
