Daily management
Anaphylaxis is preventable and treatable. Knowing the triggers and avoiding them is the first step in preventing an allergic reaction.
Awareness
People at risk of anaphylaxis need to:
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Be aware that small amounts of a food can trigger a serious allergic reaction
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Recognise the signs and symptoms of a mild or moderate allergic reaction and the signs and symptoms of a severe allergic reaction/anaphylaxis;
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Know what to do if a severe allergic reaction/anaphylaxis occurs;
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Be aware that some people don’t show signs of a mild to moderate reaction, they may promptly start having a severe reaction without any skin signs such as swelling, hives or skin flushing.
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Wear a medical identification bracelet or necklace. This may help first aiders or medical personnel identify what is happening in an emergency;
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Always carry (and know how to use) your adrenaline (epinephrine) injector (such as EpiPen®, Anapen®);
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Understand that a second dose of adrenaline is sometimes required so two injectors may need to be carried by those at high risk (talk to your doctor).
Avoidance
Removing allergens from the house makes life much easier for the allergy sufferer ; however this isn’t always possible, particularly if the allergen is egg or milk, often staple, healthy foods for most of the family. Always read food labels on purchasing foods and then again when about to eat them.
If you do have the allergen in your home, try these tips:
Wash contaminated kitchen utensils in hot soapy water or in the dishwasher .Use disposable paper towelling to wipe surfaces where the allergen has been used so you won’t contaminate your everyday sponge or dishcloth.
If egg allergic, use a sealed labelled container in the fridge to contain foods like mayonnaise, eggs, Pavlova, left over quiche, or muffins. This system can also help children recognise foods they cannot have and prevents the likelihood of inadvertently giving the allergen to the person with food allergy. Alternately use a labelled basket in the fridge and/or pantry for foods that are safe for the person with a particular food allergy to eat. Place it on the top shelf of the fridge so other foods cannot spill into it.
Use separate oil for cooking food for the person with a food allergy. If the allergen has been cooked in the same oil, it becomes contaminated.
Action
Quick action saves lives. Adrenaline (epinephrine) acts as a natural "antidote" to some of the chemicals released during severe allergic reactions. Adrenaline is the first aid, first line emergency treatment for anaphylaxis whether the trigger is food, medication, bites/stings or even exercise.
Research shows that fatalities mostly occur away from home and in situations where adrenaline is not used, or there is a delay in using it.
In Australia, two adrenaline injectors can be purchased on authority through the Pharmaceutical Benefits Scheme (PBS) at any one time. Once they are used or they expire, they can be replaced under the PBS scheme.
Adrenaline injectors deliver an intra-muscular injection (into the mid, outer thigh muscle) of adrenaline for the emergency treatment of anaphylaxis.
Devices: EpiPen® Jr 150mcg; Anapen® Junior 150;
Usage: As per ASCIA Guidelines for Adrenaline Autoinjector Prescription the 150mcg dose of adrenaline is for babies and children weighing between 7.5 – 20kg*
Devices: EpiPen® 300mcg; Anapen® 300;
Usage: As per ASCIA Guidelines for Adrenaline Autoinjector Prescription the 300mcg dose of adrenaline is for individuals weighing more than 20kg
Device: Anapen® 500;
Usage: As per ASCIA Guidelines for Adrenaline Autoinjector Prescription the 500mcg dose of adrenaline is for individuals weighing more than 50kg
*Babies who weigh less than 7.5kg are sometimes prescribed the Jr version (150mcg) of an adrenaline/epinephrine injector if their doctor feels it is safer for them to have the device because of their previous allergic reaction(s). The device can be administered to them following instructions on their ASCIA Action Plan for Anaphylaxis.
The more you know about your allergy, the more confident you will be in managing it, educating those around you and responding appropriately when faced with an emergency situation.
Be sure that you consult your doctor for information on allergic reactions and life-saving, emergency treatment. Most importantly, ensure the information you rely on is up to date and from a credible, reliable source.
More information on injectors and first aid is available on the Australasian Society of Clinical Immunology and Allergy (ASCIA) website
Content updated July 2021