ANAPHYLAXIS: ALL THAT YOU NEED TO KNOW ABOUT!!
WHAT IS ANAPHYLAXIS ?
Anaphylaxis is a potentially deadly allergic reaction that is rapid in onset. It is most often triggered by foods, medications, and insect stings. There are many other possible triggers.
Anaphylaxis is an unpredictable condition. Many people who experience it have known allergies, and some people have had one or more allergic reactions previously. Others, who are not even aware that they have an allergy, can suddenly experience severe anaphylaxis. Even the first episode of anaphylaxis can be fatal.
SYMPTOMS
Symptoms of anaphylaxis generally begin within minutes to one hour or so after exposure to a trigger.
Anaphylaxis can cause symptoms throughout the body:
●Skin – Itching, flushing, hives (urticaria), swelling (angioedema)
●Eyes – Itching, tearing, redness, swelling of the skin around the eyes
●Nose and mouth – Sneezing, runny nose, nasal congestion, swelling of the tongue, metallic taste
●Lungs and throat – Difficulty getting air in or out, repeated coughing, chest tightness, wheezing or other sounds of labored breathing, increased mucus production, throat swelling or itching, hoarseness, change in voice, sensation of choking
●Heart and circulation – Dizziness; weakness; fainting; rapid, slow, or irregular heart rate; low blood pressure
●Digestive system – Nausea, vomiting, abdominal cramps, diarrhea
●Nervous system – Anxiety, confusion, sense of impending doom


A severe form of anaphylaxis causes sudden collapse without other obvious symptoms, such as hives or flushing. This form of anaphylaxis occurs most commonly after a person is given a medication into a vein or is stung by an insect.
Up to 20 percent of people with anaphylaxis have biphasic (two-phase) anaphylaxis, in which symptoms resolve and then recur without further exposure to the trigger. This can occur up to eight hours after the initial symptoms and sometimes longer.
TRIGGERS
Common anaphylaxis triggers can include:
●Foods – In children, hen's eggs, cow's milk, peanuts, tree nuts, fish, wheat, and soy are the most common food triggers.
In teens and adults, peanuts, tree nuts, fish, and crustaceans (shellfish such as shrimp) are the most common triggers.
Any food, including fruits, vegetables, seeds, and some spices and food additives, can cause anaphylaxis.
●Medications, such as antibiotics (penicillins and cephalosporins) and analgesics (aspirin, ibuprofen).
●Venom from insects, including bees, yellow jackets, wasps, hornets, and fire ants.
●Latex from natural rubber, found in some latex gloves, balloons, condoms, sports equipment, and medical supplies.
●Exercise, either by itself or after food ingestion (eg, wheat, celery, shrimp, or other food) or after medication ingestion (eg, aspirin, ibuprofen).
●Less common triggers include exposure to airborne allergens (such as horse dander), human seminal fluid, cold water, or cold air.



RISK FACTORS
  • Previous severe anaphylactic reactions – People who have had allergic reactions to a particular substance in the past are at increased risk of anaphylaxis.
  • Asthma and other chronic lung diseases – People with asthma or other chronic lung disease are more likely to have more severe respiratory problems during anaphylaxis.
  • Other diseases – People with cardiovascular disease, for example, and coronary artery disease, are also at greater risk of severe anaphylaxis.

DIAGNOSIS
The diagnosis of anaphylaxis is based on symptoms that occur within minutes to a few hours after exposure to a potential trigger, such as a food, medication, or insect sting
ANAPHYLAXIS TREATMENT
A person who has had an anaphylactic reaction should talk with his/her health care professional and develop an anaphylaxis emergency action plan for responding to future reactions.
A critical component of the plan is having an epinephrine autoinjector available at all times and knowing when and how to use it.
Get emergency help — Because anaphylaxis can be life-threatening, it should be treated as a medical emergency. If you are experiencing a sudden allergic reaction that might be anaphylaxis, use your epinephrine autoinjector, and then call emergency medical services (or have someone else call for you). If you are home alone, make sure that the door is unlocked so that the emergency team can enter.
Self-treatment with epinephrine — If you have a history of anaphylaxis, you should always carry at least one epinephrine autoinjector with you at all times.
Epinephrine is the only medicine that optimally treats anaphylactic reactions. It is most effective when it is given promptly, before symptoms become severe. Neither antihistamines, which mainly relieve hives and itching, nor asthma inhalers (puffers), which mainly relieve coughing and wheezing, can fully treat anaphylaxis effectively. These medications should not be substituted for epinephrine.
Remove the cause — The trigger for the anaphylactic reaction should be promptly removed, whenever possible. 
Go to the hospital — After injecting epinephrine, it is important to be evaluated in a hospital emergency department where doctors and nurses can monitor you and if necessary, give oxygen, insert a breathing tube (endotracheal tube) to keep your airways open until the reaction resolves, and treat shock if it occurs. When needed, extra doses of epinephrine, intravenous fluids, and other medications can also be given.
There is an additional reason to go to the emergency department. Up to 20 percent of people with anaphylaxis have biphasic (two-phase) anaphylaxis, in which symptoms resolve and then recur without further exposure to the trigger. There is no good way to predict whether a biphasic reaction will occur. Because of this, many allergy specialists advise patients to go to the emergency department to be monitored and treated again if the symptoms do recur.
 PREVENTION
Anaphylaxis is a frightening experience. The following steps can help to reduce the risk of a future anaphylactic reaction:
See an allergist — Anyone who has experienced an anaphylactic reaction should be evaluated by a doctor with specific training and experience in the diagnosis and treatment of anaphylaxis who can help you to prevent recurrences.
Testing to determine the trigger — It is important to confirm the trigger(s) of the anaphylactic reaction. Allergists can perform and interpret skin or blood tests to confirm your specific anaphylaxis trigger(s).
For the most reliable results, skin tests should be performed at least four weeks after an anaphylactic reaction because if done too soon after the event, such tests may give negative results when the person truly does have an allergy. Antihistamines and certain other medications need to be stopped for at least five days before skin tests are performed.
In some cases, allergy tests do not identify any specific trigger. This condition is called idiopathic anaphylaxis. Some people have too many mast cells or overly active mast cells. It is more common in adults than in children. An allergist can provide the best advice about how to assess this condition (other laboratory tests may be needed) and how to manage it.
Avoiding triggers — When a trigger has been identified, you should avoid it.
Foods — If you have experienced an anaphylactic reaction due to a food, you should eliminate that food from your diet. This requires that you read and understand food labels and ask about the preparation and content of all food labels, and when eating away from home, ask about the preparation and content of all foods. This recommendation applies to snacks as well as meals and to everything that you plan to ingest, not just the foods that are most likely to contain the trigger
An allergist can provide strategies for identifying allergens in processed/packaged foods and when dining out.
Insect stings — People with an allergy to a stinging insect (bees, yellow jackets, wasps, hornets, or fire ants) should wear protective clothing, including closed shoes, and if allergic to yellow jackets, should avoid drinking from open beverage containers outdoors.
A course of allergy shots is recommended for anyone who has had an anaphylactic reaction after an insect sting. The injections are typically given for five years. They dramatically reduce the person's risk of another episode of anaphylaxis.
Medications — If you have an allergy to a medication, you should learn and record all of the different names of that medication and the settings in which you are likely to encounter it. Ask your health care providers to note your drug allergy in your medical record and consider a medical identification device.

Wear medical identification — People who have experienced an anaphylactic reaction should wear a medical identification bracelet or similar medical identification tag at all times. If another reaction occurs and you are too ill to explain your condition, the words "anaphylaxis" or "anaphylactic reaction" will help emergency responders provide prompt and proper care.
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