It takes two to tackle extreme reactions

Dr Vindi Bhandal. EMN-181210-160136001
Dr Vindi Bhandal. EMN-181210-160136001

Dr Vindi Bhandal, a senior partner at Sleaford Medical Group, is penning a monthly series of medical features with The Standard, focusing on topics regarding wellbeing and health concerns for Sleaford people, along with simple medical advice. This month she writes following recent national media reports surrounding a shortage of a certain brand of adrenaline injector pens due to production issues...

This month I would like to raise awareness of anaphylaxis, which is a severe allergic type reaction, of rapid onset which can cause breathing difficulties or collapse.

It is potentially life threatening and requires immediate treatment with adrenaline. The use of auto adrenaline injectors (AAI - there are three devices that can be prescribed Epipen, Jext and Emerade) is the first line treatment for anaphylaxis.

For individuals who have been diagnosed as being at continued risk of anaphylaxis, in an emergency setting AAI’s allow early treatment and can be life saving. It is however only one step in the management of anaphylaxis.

Individuals who have needed emergency treatment with an AAI for the first time need referral to a specialist allergy clinic in order to make a risk assessment to determine the need for continuing need for an AAI. This requires accurate diagnosis, identification of the allergen, assessment of severity and future risk from the allergen to the individual along with other factors such as a history of asthma.

An allergen can be one of numerous substances like nuts or food colourings in food products, or specific foods like shellfish or strawberries. Other substances such as medications, hair dye, chemicals, stings or plants that come into contact with the skin may cause an allergic reaction.

It is recommended that, to be prepared for any problems with supply as experienced recently, people prescribed an AAI should carry two different brands, although only one may be required for self administration during a reaction. They or their carers should be trained in both when and how to use the device. They should have a written management plan available, with education about allergen avoidance.

Also, be aware that there is an expiry date for the device and ensure replacement.