ALLERGIES + ANAPHYLAXIS

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ALLERGY: a localised immune system response to substances in the environment that are harmless for most people. These substances are known as allergens and include pollen, dust and smoke. (ASCIA, 2018)

Common symptoms of an allergic response include: localised swelling and redness, itchy skin (urticaria or hives), itchy eyes, welts, runny nose (rhinitis), tingling mouth and abdominal pain.

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Treatment:

1. Remove the trigger (or remove patient from trigger)

2. Rest and reassure patient

3. Relieve localised swelling and itch (eg: cold compress, gel)

4. Consult patient Allergy Management Plan if available

5. Consider antihistamine treatment

Interesting Fact: allergy affects around 1-in-5 people in Australia.

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ANAPHYLAXIS: an acute, generalised and severe allergic reaction that affects more than one body system, i.e systemic. It is characterised by rapidly developing airway or breathing problems with swelling, redness or itching of the skin, eyes, nose, throat or mouth. (ARC 2016)

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Common symptoms of an anaphylaxis include: difficult / noisy breathing, wheeze or persistent cough, swelling of face and tongue, tightness in throat, hoarse voice, dizziness, reduced level of consciousness, abdominal pain and vomiting, hives, welts and redness. The RASH acronym detailed below is a good reminder of what constitutes anaphylaxis with 2 out of the 4 RASH criteria showing a systemic reaction. 

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Treatment:

1. Remove the trigger (or remove patient from trigger)

2. Lay patient flat; rest and reassure

3. Administer EpiPen (adrenaline) - EARLY!

4. Administer oxygen (if available and trained to do so)

5. Give asthma medication for respiratory symptoms (if indicated)

6. Prepare for delivery of subsequent EpiPen doses - be aware of

   rebound anaphylaxis

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Evacuation: Consider: Any abnormal reaction or first time exposure with systemic involvement Rapid: Any patient who requires EpiPen administration