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Allergic reactions require quick response and follow up

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The news in the United States has been filled with stories about the high cost of the EpiPen, a life-saving medication that if administered quickly could save the life of someone suffering from anaphylaxis.

Anaphylaxis (pronounced ana-fi-lax-is) is a life-threatening allergic reaction that can occur quickly — as fast as within a couple of minutes of exposure to an allergen. Common triggers are food such as peanuts and shellfish, ant bites, insect stings, medications and latex. Exercise-induced anaphylaxis is also possible. Sometimes, there is no known cause of anaphylaxis.

The EpiPen is an injection containing epinephrine, a chemical that narrows blood vessels and opens airways in the lungs. These effects can reverse severe low blood pressure, wheezing, severe skin itching, hives, and other symptoms of an allergic reaction.

Anaphylaxis can be different for everyone. Sometimes it is a mild allergic reaction, or it can be fatal. I have seen people who accidentally eat food with peanuts or shrimp and they often feel a tingling in their lips and watery eyes that eventually go away. I have also seen severe reactions with difficulty breathing, weak pulse, shortness of breath, fainting and hives that, if not treated quickly, may result in death.

According to the American College of Allergy, Asthma & Immunology, anaphylaxis symptoms occur suddenly and can progress quickly. The early symptoms may be mild, such as a runny nose, a skin rash or a “strange feeling”. These symptoms can quickly lead to more serious problems, including trouble breathing, hives or swelling, tightness of the throat, hoarse voice, nausea, vomiting, abdominal pain, diarrhea, dizziness, low blood pressure, rapid heartbeat, and cardiac arrest.

Allergists and emergency physicians have teamed up to create the Be S.A.F.E. action guide to help us remember steps to take during and after an allergic emergency.

Seek immediate medical help. Call 911 or radio for help while at sea and get to the nearest emergency facility at the first sign of anaphylaxis, even if you have already administered epinephrine. Anyone who has had an anaphylactic reaction in the past is at risk of future reactions.

Identify the Allergen. Think about what the victim might have eaten or come in contact with – food, insects, medication, latex – to trigger an allergic reaction. It is important to identify the cause because the best way to prevent anaphylaxis is to avoid its trigger.

Follow up with an allergist/immunologist, a physician who specializes in treating asthma and allergies. It is important to consult an allergist for testing, diagnosis and ongoing management of an allergic disease.

Carry Epinephrine for emergencies. Kits containing fast-acting, self-administered epinephrine are commonly prescribed for people at risk of anaphylaxis. Those people must make sure that family, crew, and friends know of the condition, the triggers and how to use the EpiPen. Many people at risk of anaphylaxis wear an emergency medical bracelet or necklace identifying them as such.

To effectively use an EpiPen, hold it firmly by the middle in a fist. An EpiPen is a single-use device. Once it is triggered, it cannot be re-used. Avoid placing a finger over either end to avoid accidentally triggering the device.

Pull off the blue activation cap on the opposite end from the orange tip that holds the needle.

Inject into the mid-outer-thigh, halfway between the knee and the hip. Remove the EpiPen and discard.

Prepare for possible side effects, and get the patient to a hospital as quickly as possible.

Yacht crew should consider asking guests to fill out a medical questionnaire to see if they have life-threatening allergies, and if they will bring epinephrine onboard. Most people with these types of allergies carry their medication with them, and most of the yachts I have conducted CPR classes onboard have epinephrine in the first aid kit.

Trained as an emergency medical technician, Keith Murray now owns The CPR School, which provides onboard CPR, AED and first-aid training as well as AED sales and service (www.TheCPRSchool.com). Comments are welcome at editor@the-triton.com.

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