Military Officer - October 2006 - (Page 40) askthedoctor Anaphylaxis Insect stings, latex, peanuts, penicillin, and shellfish — though harmless to most people, each can trigger this serious, sudden allergic response. By Rear Adm. Joyce Johnson, D.O. N Be Prepared for an Anaphylactic Crisis ■ If you’re at risk for an anaphylactic reaction, carry an epinephrine autoinjector with you at all times — and make certain you (and others) know how to use it. o one knows why some people have specific allergies while others don’t. About 2 percent of the population has an allergy to some type of food, and food allergies are responsible for thousands of emergency room visits and about 150 deaths in the U.S. annually. Common food allergies include peanuts, shellfish, fish, and eggs. Allergic reactions to insect bites cause another 50 deaths annually. When an allergic person is exposed to a food, medicine, insect venom, or other allergen, his or her body recognizes it as foreign and produces antibodies in reaction. The next time it is exposed, the body begins an allergic response that includes the release of histamines and other chemicals. Allergic responses range from fairly minor to life-threatening; anaphylaxis is at the serious end of the spectrum. Anaphylaxis usually (but not always) occurs within a few minutes of exposure to an allergen. It affects many body systems: The skin might develop hives, an itchy rash. The eyes and lips can swell, as can the mouth and throat — making swallowing difficult. Breathing can be impaired. Blood pressure might drop, sometimes causing a loss of consciousness. Diarrhea and vomiting are other possible symptoms. Sometimes people having anaphylaxis report “feeling strange.” Sudden death is a possibility. Anaphylaxis is a true medical emergency. If you suspect someone is having an anaphylactic reaction, immediately call 911 and describe the situation to the dispatcher. If the patient has an epineph- rine pen, use it. Be ready to give CPR if it’s needed before the ambulance arrives. If you have a known allergy and your doctor has prescribed an EpiPen, Twinject, or similar device for you, fill the prescription and carry it with you at all times. Some people have several to keep at home, in the office, and on their person. Make certain that coworkers, friends, family members, and others who spend time with you know how to use it. Teachers, camp counselors, and others should be told that a child has an epinephrine auto-injector, and they should be trained to help the child use it in case of emergency. Store epinephrine at room temperature, and check it periodically (at least annually) to make certain it has not expired. Replace it when it reaches the expiration date. The best prevention is to avoid an allergen. Read food labels. Wear protective clothing and use care to avoid insect stings and bites. People with egg allergies also should avoid some vaccines, such as flu shots, that are egg-based. However, it is sometimes difficult to know what you are allergic to. After your first reaction, take a careful inventory of foods, medications, and other exposures. Share this list with your doctor, who can help you identify which might be the most likely cause. MO — Rear Adm. Joyce Johnson, USPHS-Ret., D.O., M.A., is vice president, Health Sciences, Battelle Memorial Institute, Arlington, Va. Find more health and wellness resources at www .moaa.org/wellness. For submission information, see page 18. PHOTO: STEVE BARRETT 40 MILITARY OFFICER OCTOBER 2006 http://www.moaa.org/wellness http://www.moaa.org/wellness
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