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 are often hidden in a variety of different preparations. 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 three 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, though somewhat less protection against fire ant reactions.
  2. Premedication is most helpful in preventing anaphylaxis from X-ray dyes. Alternative dyes that are less likely to cause reactions may be available.
  3. 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.

Anyone known to be at risk for anaphylaxis should wear a Medic-Alert bracelet that clearly states the allergic trigger, the risk of anaphylaxis, and the availability of an epinephrine kit.

People with anaphylaxis to medications should take new medications by mouth whenever possible since the risk of anaphylaxis is higher with injections.

Table 2: Basic Avoidance Measures for Anaphylaxis
TriggerAvoidance Principle
  • Advise all health-care personnel of any allergies.
  • Ask a doctor whether the prescribed medication contains the drug(s) one is allergic to.
  • Take all drugs by mouth if possible.
Insect stings
  • Avoid areas such as outdoor garbage, barbecues, and insect nests.
  • Avoid bright clothing, perfume, hair spray, or lotion that might attract insects.
  • Wear long-sleeved clothing, long trousers, and shoes while outdoors.
  • Carefully read all labels.
  • Many candy bars will now indicate if they were produced in a peanut-free environment.
  • Ask what the ingredients are when eating out.
  • Speak directly with the cook/chef to assure that cooking utensils are not used for the preparation of other dishes that one may be allergic to.
  • Avoid foods that may cross-react, such as bananas, kiwi fruit, and avocado.
  • Avoid all latex products.
  • 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 epinephrine injection kits designed for self-administration. These kits are available by prescription only and come in two forms:

  • EpiPen is a spring-loaded automatic syringe that delivers a predetermined dose (0.3 mg) when the tip is pressed hard for several seconds. An EpiPen junior is available for children under 33 pounds and contains half of the dose.
  • Ana-kit contains a preloaded syringe and needles with two 0.3 mg doses of epinephrine. These are injected under the skin or into the muscle of the thigh. An antihistamine, alcohol swab, and a tourniquet are included in the kit.

Here are some important points to remember regarding the kits:

  • Ask a doctor to explain the use of the kit carefully and practice with the demonstrator kit.
  • Check expiration dates and replace outdated kits.
  • Keep kits out of direct sunlight, which may affect the drug.
  • Additional kits should be brought to school or work.
  • Always have kits readily available.
  • Make sure that friends, relatives, exercise buddies, 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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