Anaphylaxis - Prevention

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If you've experienced anaphylaxis, how do you prevent another occurrence? Do you have an EpiPen?

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Is it possible to prevent anaphylaxis?

Preventing anaphylaxis is the ideal form of treatment. However, that may not always be easy since insect stings are frequently unanticipated, and allergens in foods may be ingested by mistake. A consultation with an allergist is vital in helping one identify the trigger(s) and providing information and instruction on how to best avoid them. The affected individual will learn how to use emergency kits and how to become prepared for any reaction in the future.

These are situations in which preventive treatment might be offered by the allergist.

  1. Allergy shots may be suggested to some people with wasp, yellow jacket, hornet, honey bee, or fire ant reactions. This form of treatment gives 98% protection against the first four insect reactions and also reduces the severity of any reactions that may occur.
  2. Premedication is most helpful in preventing anaphylaxis from IVIV contrast. Alternative dyes that are less likely to cause reactions may be available.
  3. Temporary induction of tolerance (also called desensitization) to problematic medications is often effective. This process is accomplished by gradually increasing the amount of the medication given under controlled conditions. Sensitivities to penicillin, sulfa drugs, and insulin have been successfully treated in this way.
  4. Food immunotherapy in which individuals are given small daily doses of a food to which they are allergic is an area of current research for milk, eggs, and peanuts but is not used in routine clinical practice at this point.
Table 2: Basic Avoidance Measures for Anaphylaxis
TriggerAvoidance Principle
Drugs/medications
  • Advise all health-care personnel of any allergies. Remember and describe symptoms involved in a reaction to previous drugs.
    • Ask a doctor whether the prescribed medication contains the drug(s) one is allergic to.
Insect stings
  • Avoid areas where stinging insects are attracted and avoid insect nests.
  • Avoid bright clothing, perfume, hair spray, or lotion that might attract insects.
  • Wear long-sleeved clothing, long trousers, and shoes while outdoors.
Food
  • Carefully read all labels. Foods containing milk, egg, peanut, tree nuts, soy, fish, and shellfish must be labeled by law.
  • Ask specifically about ingredients when eating at restaurants.
  • Do not eat foods with unknown ingredients.
  • It is typically best to avoid foods with precautionary labeling ("may contain," "made in a factory with," etc.).
Latex
  • Avoid all latex products.
  • Inform health-care professionals of latex allergy.
  • Make sure the hospital or doctor's office has latex-free supplies.

Since avoidance is not fail-safe, a person at risk for an anaphylactic reaction must be adequately prepared in an emergency to handle a reaction. It is recommended that everyone at risk carry self-injectable epinephrine (EpiPen or Adrenaclick).

Here are some important points to remember regarding self- injectable epinephrine:

  • Ask a doctor to explain the use of the device carefully and practice with the demonstrator kit.
  • Check expiration dates and replace outdated devices. The expiration date must be followed for epinephrine.
  • Keep devices out of extremes of temperature since this influences drug stability.
  • Additional devices should be brought to other homes, school, or work.
  • Always have two devices readily available.
  • Make sure that friends, relatives, exercise partners, and coworkers are aware of one's condition and know what to do in case of a reaction.
Return to Anaphylaxis

See what others are saying

Comment from: Rabbit, 45-54 Female (Patient) Published: September 25

I live on my own. I have had allergies all my life and asthma, but no food allergies until one night I was eating Brazil nuts (a favorite that I ate at Christmas throughout my childhood). I went to bed and my hands started burning and violently itching. I put them under the cold tap. I went back to bed, thinking I would call the doctor the following day. The next thing, my whole body, and especially my groin, were violently itching and burning. I got a hair brush to my body. Next thing, I feel my throat and tongue swelling and pressure increasing in my ears. At that point I called the ambulance and opened the front and porch doors to let them in. I was half conscious when they arrived, and they couldn't find me to start with. That was scary because they might go away again. They got me in the ambulance and treated me there and then with steroids, antihistamine, oxygen and I don't really know what else. My breathing was getting worse. I had a reaction to the steroids, and my groin went ballistic, all hot and stinging. They took me to the hospital and I was treated in crash, again with steroids, antihistamines and other drugs. I was kept in overnight. As a result of the attack, there are now broken veins all over my cheeks, permanently. I have since had smaller reactions, to wheat in particular. It was very frightening, and only because I worked in a hospital for 20 years did I know what it was and call for the ambulance when I did. It made me realize just how much I want to live.

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Comment from: Two Hawks, 55-64 Male (Patient) Published: December 19

My allergist ordered an allergy test and found that I had developed a severe reaction to all tree nuts. After the first of six trips to the emergency room (there is a learning curve, tree nuts are in a lot of things), I read all food labels, and have cut down on processed foods. And I made up a small waist pack first aid kit that I carry everywhere I go. The two Epi-pens, Benadryl, albuterol, beclomethasone, prednisone and a printout on 'anaphylaxis emergency action plan' with contact info, my stats, and a marker pen to note time when/what medicines taken. First responders were amazed at my life saving kit. Still have to go to the emergency room just to make sure all stays well. You need to avoid all allergens and learn all there is to know about this condition. Stay safe.

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