Anaphylaxis is a severe acute allergic reaction that progresses quickly and can lead to death; therefore, immediate medical attention is necessary.

It occurs when an individual is exposed to an allergen. An allergen is a substance which causes the allergic reaction.

As mentioned, the anaphylactic reaction occurs quickly…within minutes. It includes the following signs:
1. Skin Reaction: Hives, redness, swelling, and itchiness, and warmth, rash. The ‘skin’ signs may or may not appear in an anaphylactic reaction.
2. Respiratory: Wheezing, shortness of breath, difficulty swallowing, coughing, chest pain
3. Stomach: vomiting, nausea, pain, diarrhea, metallic taste, itchiness on the palate in the mouth.
4. Cardiovascular: Dizzy, light headed, pale-bluish complexion, weak rapid pulse, feel faint, and pass out, a rapid decrease in blood pressure.

If the anaphylactic reaction is severe enough (and they often are), the airways swell and the individual cannot breathe. In addition, the blood pressure drops quickly and the patient passes out.

Steps to deal with an Anaphylactic Reaction
• Epinephrine, in the form of an epi-pen.
• Call 911.
• Five to fifteen minutes later, give a second dose of epinephrine if required (it usually is).
• Go to the hospital. Even if the symptoms disappear, you should still go to the hospital…they may reappear hours later even after use of the epi-pen.

What does Epinephrine do?
1. Returns the blood pressure to normal.
2. Opens up the airways…air flow returns.

The Role of Anti-Histamines
Antihistamines are not a first line of defense in treating an anaphylactic reaction. They are not effective at stopping the severe symptoms that arise. It is best to use anti histamines to treat skin rashes and hives.

Please keep in mind that epinephrine is the first line of defense: it should be injected into the muscle on the outer side of the thigh.

Common Causes of Anaphylaxis
1) Food: I.e. peanuts, soy, milk, eggs.
2) Medication: I.e. penicillin.
3) Insect bite: I.e. bee stings.
4) Latex: found in dental examination gloves.

It’s important for everyone to know about anaphylaxis, because so many more people have allergies these days as compared to years ago; they are just more common.

In the next series of blogs we’ll look at different allergies that we encounter in the dental field…until then.


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