Allergic Reaction Is Localized

Allergic reactions primarily only affect the area where the allergen made contact with the patient. Allergic reactions generally only require supportive care. Ice can be applied to the site for pain relief and to decrease the swelling.

Anaphylaxis Is Everywhere

Anaphylaxis is a life-threatening condition. Anaphylaxis creates system wide problems for the patient which will only get worse as time continues. The following are symptoms of anaphylaxis:

• Severe respiratory distress
• Wheezing
• Rapid heart rate
• Hypotension
• Pale, red, or cyanotic skin
• As blood pressure drops, altered mental status
• As time continues, stridor heard as laryngeal edema constricts the trachea.
• Angioedema or swelling to the neck, face, lips, eyelids

Putting It All Together

Initial management of anaphylaxis is guided by the primary survey

Patients with anaphylaxis need epinephrine. Epinephrine injection is used along with emergency medical treatment to treat life-threatening allergic reactions caused by insect bites or stings, foods, medications, latex, and other causes. Epinephrine is in a class of medications called alpha- and beta-adrenergic agonists (sympathomimetic agents). It works by relaxing the muscles in the airways and tightening the blood vessels. As with all medications, the administration of epinephrine requires a physician’s order. It is very possible that the medical director of a particular jurisdiction will write a protocol or standing order that will allow the medics to administer the medication without making direct contact. Regardless, epinephrine is a drug and must be given under the supervision of a physician. The use of epinephrine is contraindicated if it’s use is not indicated or the medication unusable because it is expired or discolored. EpiPen is an epinephrine auto-injector that is typically prescribed to the patient by their doctor. EpiPen comes in age dependent doses (EpiPen, Jr.). If administering a patient’s EpiPen, make sure it was prescribed to the patient.