Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
The optimal management of anaphylaxis saves lives. An
affected or at-risk person must be aware of possible
triggers and early warning signs. If you are prone to these
reactions, you must be familiar with the use of emergency anaphylaxis treatment
kits and always have them with you.
If you are aware of what triggers severe reactions and potentially anaphylaxis, a wrist bracelet indicating this can be helpful in case of unresponsiveness. Emergency measures and
prevention are central to management. As always, allergic
diseases are best treated by avoidance measures, which will
be reviewed in detail below.
What are emergency measures used in the
treatment of anaphylaxis?
If you suspect that you or someone you are with is
having an anaphylactic reaction, the following are
important first aid measures. In general, try to perform
these in the order that they are presented.
Call emergency services or 911 IMMEDIATELY.
If the patient has an EpiPen, inject epinephrine immediately. The shot is given into the outer thigh and can be administered through light fabric. Rub the site to improve absorption of the drug.
Place a conscious person lying down and elevate the feet if possible.
Stay with the person until help arrives.
If trained, begin CPR if the person stops breathing or doesn't have a pulse.
Shots of epinephrine can be given through light clothing such as trousers, skirts, or stockings. Heavy garments may have to be removed prior to injecting. Only inject epinephrine if the patient has a history of anaphylactic reactions or under guidance of a health-care provider.
After 10 to 15 minutes, if the symptoms are still significant, you can inject another dose of epinephrine if available. Even after the reaction subsides, you need to go to an emergency department immediately. Other treatments may be given, such as oxygen, intravenous fluids, breathing medications, and possibly more epinephrine. Steroids and antihistamines may be given, but these are often not helpful initially and do not take the place of epinephrine. However, they may be more useful in preventing a recurrent delayed reaction.
Do not be surprised if epinephrine makes you feel shaky and
causes a rapid, pounding pulse. These are normal side
effects and are not dangerous except for those with severe
heart problems.
Anxiety is a feeling of apprehension and fear characterized by physical symptoms. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults.
Hives, also called urticaria, is a raised, itchy area of skin that is usually a sign of an
allergic reaction. The allergy may be to food or medications, but usually the
cause of the allergy (the allergen) is unknown.
Nausea is an uneasiness of the stomach that often precedes vomiting. Nausea and vomiting are not diseases, but they are symptoms of many conditions. The causes of vomiting differ according to age, and treatment depends upon the cause of nausea and vomiting.
Itching can be a common problem. Itches can be localized or generalized. There are many causes of itching to include: infection (jock itch, vaginal itch), disease (hyperthyroidism, liver or kidney), reactions to drugs, and skin infestations (pubic or body lice). Treatment for itching varies depending on the cause of the itch.
The most common food allergies are to eggs, nuts, milk, peanuts, fish, shellfish, strawberries and tomatoes. Symptoms and signs include nausea, vomiting, diarrhea, abdominal pain, itching, hives, eczema, asthma, lightheadedness, and anaphylaxis. Allergy skin tests, RAST, and ELISA tests may be used to diagnose a food allergy. Though dietary avoidance may be sufficient treatment for mild allergies, the use of an Epipen may be necessary for severe food allergies.
An allergy refers to a misguided reaction by our immune system in response to bodily contact with certain foreign substances. When these allergens come in contact with the body, it causes the immune system to develop an allergic reaction in people who are allergic to it. It is estimated that 50 million North Americans are affected by allergic conditions. The parts of the body that are prone to react to allergies include the eyes, nose, lungs, skin, and stomach. Common allergic disorders include hay fever, asthma, allergic eyes, allergic eczema, hives, and allergic shock.
Dysphagia or difficulty in swallowing, swallowing problems. Dysphagia is due to problems in nerve or muscle control. It is common, for example, after a stroke. Dysphagia compromises nutrition and hydration and may lead to aspiration pneumonia and dehydration.
Mercury is a naturally occurring element found in water, soil, and the air. Mercury is also contained in some fish, some of the products we use in the home, school, or dentist. Information about sources of mercury exposure, potential health effects, symptoms of exposure, fish that may contain mercury, consumer products that contain mercury, and ways to reduce your exposure to mercury is important for the health of you, and your family.
The majority of spiders in the United States are harmless. Two exceptions include the black widow spider and the brown recluse spider. Symptoms of a harmless spider bite generally involve redness, irritation, and pain. alized symptoms of bites from black widow and brown recluse spiders may include: nausea and vomiting, fever, headache, abdominal pain, joint pain, and more. In general, a brown recluse spider bite or black widow spider bite may require medical attention. The information includes pictures of the brown recluse and black widow spiders for identification.
Medical shock is a life-threatening medical condition. There are several types of medical shock, septic shock, anaphylactic shock, cardiogenic shock, hypovolemic shock, and neurogenic shock. Causes of shock include heart attack, heart failure, heavy bleeding (internal and external), infection, anaphylaxis, spinal cord injury, severe burns, chronic vomiting or diarrhea. Low blood pressure is the key sign of sock. Treatment is dependant upon the type of shock.
Bees, wasps, and fire ants are related insects that belong to the Hymenoptera order. There are thousands of species of wasps found throughout the world. Common wasps are yellow jackets and hornets. Types of bees include honey bees, the Africanized honey bee (killer bee), and the bumble bee. There are four types of reactions to a bee or wasp sting; 1) local reaction, 2) systemic allergic reaction, 3) toxic reaction, and 4) delayed reaction. Individuals who have a systemic or toxic reaction generally require immediate medical treatment to prevent anaphylactic reaction, and possibly death.
Regular physical activity can reduce the risk of disease. Regular exercise can also reduce the symptoms of stress and anxiety. There are fitness programs that fit any age or lifestyle.
Bug bites and stings have been known to transmit insect-borne illnesses such as West Nile virus, Rocky Mountain spotted fever, and Lyme disease. Though most reactions to insect bites and stings are mild, some reactions may be life-threatening. Preventing bug bites and stings with insect repellant, wearing the proper protective attire, and not wearing heavily scented perfumes when in grassy, wooded, and brushy areas is key.
The majority of stinging insects in the United States are from Bees, Yellow Jackets, Hornets, Wasps and Fire Ants. Severity of reactions to stings varies greatly. Avoidance and prompt treatment are essential. In selected cases, allergy injection therapy is highly effective.
First aid is a complicated subject and it is situation-specific. First aid is the help and medical assistance that someone gives, not only to an injured person, but to a person who is sick. Preparedness is a key element of first aid, like having basic medical emergency kits in your home, car, boat, or RV. Cuts, puncture wounds, sprains, strains, nosebleeds are one type of injury that may require first aid; heart attacks, strokes, seizures, and heat stroke are examples of more critical first aid emergencies.
Drug allergies are cause when the immune system mistakenly creates an immune response to a medication. Symptoms of a drug allergic reaction include hives, rash, itchy skin or eyes, dizziness, nausea, diarrhea, fainting and anxiety. The most common drug allergy is penicillin. Treatment may involve antihistamines or corticosteroids. An Epipen may be used for life-threatening anaphylactic symptoms.
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