Anaphylactic attack - when an allergy can kill you

Anaphylactic attack or anaphylaxis is a severe type of allergic reaction. Dr Dhiraj Bhattad tells us how to manage it.

What comes to your mind when someone says the word allergy? Probably someone sneezing or maybe some red blotches on the skin, but did you know that an allergic reaction can lead to much more than just superficial symptoms? Also known as an anaphylactic attack, this reaction can often be sudden and cause severe symptoms like choking, organ failure and even death. We spoke to Dr Dhiraj Bhattad, consultant internal medicine at Seven Hills hospital about the condition and how one should be prepared in the case of an emergency.

An anaphylactic attack or anaphylaxis is a severe type of allergic reaction. In the process of fighting a foreign agent, the body produces a large number of chemicals that cause harm to the body itself. The culprit may be certain medicines (eg. Penicillin), an insect bite (eg. bee sting), certain foods (eg. peanuts) or products (eg. Latex rubber). Although these are the common causes there is scientific data that says that about one fourth of the anaphylactic attacks seen do not have any specific cause.

Recognizing anaphylaxis

The symptoms may vary from mild to severe ones. The person may have skin swelling, rash, flushing, itching, swelling of face or tongue, running nose, hoarseness of voice, chest tightness, breathlessness, fast heart beats, severe anxiety or feeling of 'impending doom', pain in abdomen, loose motions, light headedness, giddiness or unconsciousness. (Read: Beware of food allergies!)

Read more about causes, symptoms, diagnosis and treatment of anaphylaxis.

How common is it?

It's a very rare condition, the lifetime risk being roughly 1%. That is approximately 1 in 2000 people/year. Most people might not experience it in their lifetime at all. But its incidence is increasing, especially to food substances.

Be prepared to provide first aid

The affected person should be removed from the environment or moved away from the substance that has caused anaphylaxis. If the person has had a previous episode of anaphylaxis and has epinephrine (adrenaline) injection with them, then it can be given in the muscle in mid-thigh area. If one does not have access to this medication, emergency medical care should be sought. Until emergency medical aid arrives, the patient should be made to lie down with his/her legs elevated (raised above the level of their chest). Calm him/her down. This will help reduce the rate of their breathing, helping them cope better with the situation. If the patient is asthmatic and has an inhaler, it can be used to reduce his/her breathlessness. Lastly if the person doesn't have a pulse or stops breathing, perform CPR (Cardiopulmonary resuscitation) , till the time help arrives. (Read: No stings attached! Home remedies for insect bites)

An anaphylactic attack is a medical emergency. Hence the patient must visit a doctor immediately, since a severe reaction can lead to death. The doctor will then be able to immediately administer an adrenaline injection and give the patient anti-allergic medications (anti-histaminics/steroids), nebulisation, oxygen or intravenous fluids if required. More importantly, after recovery, the person must take care not to get re-exposed to the causative allergen. As a precaution a patient with a severe allergy should carry an identity card or bracelet, that mentions his/her allergy and susceptibility to anaphylaxisis . A known patient of anaphylaxsis should also carry anti-allergic medicine (anti-histaminics) and adrenaline injection for self administration, in the case of an emergency.

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