Common Questions about Allergies: Answered
I’ll update this post regularly with FAQ’s I get as an allergy mum!
What is Epinephrine (a.k.a. Epi) is it the same thing as an epi-pen?
epinephrine (the medication in the auto-injector) is adrenaline - do not be afraid to use it. Adrenaline is the only first line treatment for anaphylaxis. (Source)
"Epi-pen” is a very well known brand of an auto-injectable device that delivers the drug epinephrine.
The brand we use is called “Auvi-q”.
Reminder: Always carry two auto-injectors.
Should I use antihistamines like Benadryl if someone is having a severe allergic reaction?
“Don't use antihistamines to treat anaphylaxis — prompt administration of adrenaline is the only treatment for anaphylaxis” - Allergy.org
“antihistamines are never a suitable medication for treating anaphylactic shock.”
“Antihistamines can potentially relieve some mild symptoms from an allergic reaction, such as an itchy mouth or hives, but they cannot stop the life-threatening symptoms of anaphylaxis.” - Red Sneakers For Oakley
Why should the Epi be injected into the thigh as opposed to any other body part?
3 of many reasons:
1. the thigh muscle is one of the largest muscles in the human body and has a lot of blood vessels, therefore it has a large/good blood supply - the greater the blood supply, the faster the absorption of the medication (epinephrine/adrenaline). If it is accidentally injected into a smaller muscle (i.e. the arm) the medication may not be absorbed fast enough to do the life saving work.
2. Additionally, there is less fat between the skin and muscle in the thigh. Adrenaline needs to be injected straight into the muscle to be most effective. (Source)
3. The thigh is the safest location for the injection. (Source)
What position should the allergic person be in during administration of the epi?
“There currently is no consensus on the ideal body position for epinephrine autoinjector (EAI) administration.”
-National Library of Medicine
Why do people carry 2 Epinephrine auto-injectors?
In some cases of anaphylaxis, one dose of epinephrine is often not enough. 35% of people may require a second injection.
Autoinjectors sometimes fail to deliver the full dose of epinephrine due to manufacturing defects. If the first auto-injector fails (you can tell if it fails as symptoms will worsen / not get better within 5 minutes after the first one) use the second one.
If there is a delay in administering the first dose of epi, an additional dose of epinephrine may be required. There is evidence that failing to administer adrenaline as soon as anaphylaxis is suspected has contributed to fatal outcomes. Delayed injection of adrenaline can also increase the likelihood of a biphasic reaction.
(Source)
Do I need to know how to use an Epi injector?
We believe that just like knowing how to perform CPR, knowing how to administer epinephrine (and practicing with a trainer!) is critical and can be life saving. Of course, family and friends should be aware of the risks of anaphylaxis, the causes, and how to administer epinephrine, but we believe the knowledge and wisdom to apply this potentially life saving work should be accessible and clear to everyone. Additionally, the correct injection technique is important to avoid unintentional injection into other body parts.
How do I use an Epinephrine auto-injector?
We made this YouTube Video on How to Use an (Auvi-Q) Epinephrine auto-injector and this Video covering some critical steps to take AFTER the epi is injected When Someone is Having an Allergic Reaction
Why do I need to call 911 if Epi is administered and the person is feeling better?
2 main reasons:
Epinephrine is NOT a "fix" to the allergic reaction. While it can stabilize the person for a short window of time, it is a critical window of time needed to get the person to the hospital where more medical treatment and monitoring can begin to keep the person alive.
A second allergic reaction, called biphasic anaphylaxis, can occur between 1 to 72 hours (typically eight hours) after the initial reaction. This happens in 20% of patients experiencing anaphylaxis. (Source)
How do we recognize symptoms of Anaphylaxis or a severe allergic reaction that require the injection of Epinephrine?
“Allergic reactions to food can have many different symptoms, and an individual can experience different symptoms from one reaction to the next. Often, reactions start with skin symptoms, like hives or a rash, but many do not. More serious symptoms like a drop in blood pressure and trouble breathing can be life-threatening.” - RedSneakers.org
“Anaphylaxis is a serious allergic reaction that comes on quickly and may lead to death. We cannot stress enough: epi first, epi fast, then call 911.”
If the person has any SEVERE SYMPTOMS (see left box below) inject the epinephrine FAST as instructed in the video here.
ORIf the person has more than 1 of the MILD SYMPTOMS (see right box below) inject the epinephrine FAST as seen in the video here.
See my previous blog post on “What to Do if Someone is Having an Allergic Reaction” for more details.
FARE's Food Allergy & Anaphylaxis Emergency Care Plan
This is what we were provided by our Allergy Specialist to help us identify if our child is going through an anaphylactic reaction.
What side effects do we expect with the epinephrine use?
Shaking, jitters, and a fast heart rate. Just like we would experience with adrenaline - epinephrine is adrenaline. Do not be afraid to use it!
How long does it take for the epi to work?
For the vast majority it works within 5 minutes. If after 5 minutes upon the first injection she/he is still struggling*, you administer the 2nd epi QUICKLY.
