Helpless Without Epinephrine Kit – Anaphylaxis
10 Apr 2006
Years ago Superman escaped from the explosion of the planet Krypton in the Superman movie. But few know that micro cinematography of an exploding human mast cell was used to depict the planet’s end. Humans are not as lucky as Superman. Every year thousands of Canadians suffer anaphylactic reactions due to exploding mast cells and many die from the massive allergic eruption. Planning ahead can prevent this tragedy.
This deadly reaction may result from the venom of a bee, yellow jacket, yellow hornet or wasp sting. Each year more North Americans die from insect bites than poisonous snakes. Others die from an antibiotic, or after eating shellfish, eggs, soy, or milk. All told 200 foods have been implicated in causing this reaction.
Mast cells are part of the immune system. They are most abundant in the skin, tongue, airways and intestine. And when stimulated by an offending substance they explode, releasing large amounts of histamine.
The victim often notices hives appearing on the skin. A few moments later the skin whitens. There may be sudden vomiting and diarrhea, followed by a feeling of impending doom. Like a boa constrictor, massive amounts of histamine close off the airway and death can result within minutes.
Every person who has survived an anaphylactic attack or parents of susceptible children live in fear of a fatal reaction. Peanut allergy is the most common cause creating headlines when death strikes.
The resulting plea from parents is to have peanuts banned from public places such as sporting events. This always triggers ethical debates. Some argue that this restriction violates the rights of those who enjoy eating peanuts.
It is possible to remove peanuts from certain locales. For instance, Air Canada stopped serving peanuts on all flights in 1998. That’s a reasonable decision as the last thing you need is an anaphylactic reaction at 35,000 feet in mid Atlantic.
But flying on Air Canada could still be hazardous. How can you be sure a traveler hasn’t carried a few peanuts aboard? Even the smell of peanuts can trigger an anaphylactic attack. And kissing someone who has eaten peanuts can be the kiss of death.
Patients with life-threatening allergies must realize we live in an imperfect world and it’s impossible to protect them from every hazard. The only way to prevent needless fatalities is to plan ahead for unexpected attacks.
Recent reports indicate that some parents have not done their homework. It’s hard to understand why when they know their child is vulnerable.
In one instance a teenage girl at a sporting event who was allergic to peanuts suddenly smelled them, and popped four antihistamine tablets. These are useful for mild allergic reactions, but antihistamine is not the first line of defense against anaphylaxis. The girl should have left the game and sought immediate help.
Later she started to develop the symptoms of anaphylactic shock. Realizing impending trouble she reached for the emergency epinephrine injection. That was the right move. But both the teenager and her parents had overlooked a vital fact. The date on the package showed the epinephrine injection had expired. Luckily this teenager survived only by good fortune.
Remember, survival of an anaphylactic reaction requires speed. A quick call to 911 or a rush to an emergency department. But suppose you’re at the cottage miles away from help. You could have the best doctor in the world present and he would be helpless without epinephrine, the time-honoured medication for exploding mast cells.
Kits are available, such as "Twinject", which contains two doses of epinephrine. One is injected into the outer thigh, quickly relaxing constricted airways and combating shock by increasing blood pressure. But if there’s no response in 10 minutes, the second dose must be given. This dose is important as up to one in three people require the second injection.
Twinject is available in two doses. For those weighing 33 to 66 pounds there’s Twinject 0.15 milligrams. For those over this weight Twinject 0.3 milligrams is appropriate. Anybody with a severe allergy should always carry a kit with them. And every cottage needs this protection. Check with your doctor if you have this problem.
For more information check the web site www.twinject.ca
