• Allergy and anaphylaxis may be caused by exposure to

materials, foods, vaccinations, insect bites, contact with

other animals and allergens.
• Anaphylaxis is an emergency that requires rapid diagnosis
and immediate intervention.
• EMTs must posses the tools to diagnose and treat patients
suffering from a severe allergic reaction.
• The immune system is based on memory and specialty.
• Our body remembers its first interaction with an antigen
(allergen) and knows how to identify when it is sensed in
the bloodstream.
• It's important to differentiate between two reactions:
 An allergic reaction
 An anaphylactic reaction
• The body has several defensive mechanisms:
 Natural barriers: skin, mucous membranes in the
airways and in the intestines
 Nonspecific mechanisms: white blood cells and an
increase in core body temperature
 Specific mechanisms: antibodies in the bloodstream
• An allergy is an excessive reaction of the immune system
to an antigen and refers to a local reaction of one system in
the body.
• The reaction is usually caused by exposure to a medication,
food or an insect bite.
• The signs and symptoms usually appear close to the point
of exposure. For example, exposure through the skin will
cause a widespread rash and exposure through the
respiratory system and might cause shortness of breath.
• An allergic reaction that affects at least two systems in the
body as a result of an antigen.
• Exposure to the antigen might take place through the skin,
the respiratory system, the digestive system or the
cardiovascular system.
• An acute allergic reaction develops extremely quickly.
• Anaphylaxis is a medical emergency that requires
immediate intervention.
When the body senses an antigen, its allergic reaction to it is
to release large amounts of histamine, which will cause:
• The respiratory system:
 Contracts the bronchi
 Secretes excessive amounts of mucus
• The cardiovascular system:
 Dilates blood vessels
 Reduces blood pressure
 Forces liquid to seep into intercellular spaces
• Skin:
 Hives, a rash and local edemas
 An antigen enters the body.

The body identifies the antigen with the help of specific antibodies.

The immune system reacts by secreting histamine that causes blood

vessels to dilate in order to allow white blood cells to reach the point
of incursion and attack “the intruder.”

The result: An inflammatory reaction, either local or systemic.

• Foods:
 Sea foods
 Eggs
 Tropical fruit
 Milk
 Sesame seeds
 Peanuts
• Medications / drugs
• Insect bites
• Pollen
This is partial list and there are many other allergens, but these are the most common.
• Preliminary stages: numbness, itching and a skin rash
• In more advanced stages: (May appear extremely quickly)
 Skin / eyes: A widespread rash, edemas, an itching
sensation of the eyes and skin.
• Respiratory system: congestion and a runny nose,
difficulty swallowing, inflammation of the tongue, wheezing,
excessive coughing.
• Cardiovascular system: dizziness, fatigue, fainting, chest
pains, palpitations, tachycardia.
• Digestive system: nausea, vomiting, diarrhea and
stomach pains.
• Nervous system: headaches, dizziness, blurred vision.
• Respiratory: The main risk is respiratory problems—a
threat to the airways as a result of edemas that block the
respiratory tract.
• Cardiovascular: Hemodynamic collapse is a result of
excessive dilation of blood vessels.

Remember, the faster the reaction,

the greater the risk!
• Support the patient’s ABC.
• Keep the patient seated and monitor and protect the
patient's airway.
• Provide oxygen using a non-rebreather (Oxygen) mask or
a BVM, if necessary.
• Inject an EpiPen (by the most senior crew member on
scene).
• Begin evacuation to hospital; transfer to an ICU
ambulance.
• Provide fluids intravenously during transport.
• Only if the patient begins to collapse hemodynamically, lay
him on his back and raise his legs to 30 degrees.
• An EpiPen is an automatic injector that contains
epinephrine (adrenaline).
• In many cases the patient will know that an EpiPen injection
is needed.
• Early injection with the EpiPen gives the patients the
necessary added time until a mobile ICU ambulance arrives
so they can be transported to the hospital.
The needle is on the
orange end of the device

Blue safety cap must be

removed
• Sudden appearance of symptoms in a range of minutes to
hours before the onset of an allergic reaction. It will be
manifested through the skin, membranes or both and
additional respiratory distress or hemodynamic instability.
or
• Two of the following: a widespread irritation of the skin,
respiratory distress, severe hypotension, ongoing digestive
symptoms (stomach pains, vomiting).
or
• A sudden drop in blood pressure after exposure to an
antigen that the patient has a known sensitivity to.
1. Pediatric injector (0.15 mg of epinephrine): green
2. Adult injector (0.3 mg of epinephrine): yellow

The needle is on the orange end

of the device
1

Blue safety cap must be

removed
1 2 3
Open the plastic Remove the injector Remove the blue safety cap
housing cap by sliding it out without touching the orange tip

4 5
Aim the injector at the
patient's thigh (with or
without clothes)
6
Quickly insert the injector into the Remove the injector
patient’s at 90°, until you hear a carefully without
click and keep the injector in touching the needle and
place for 10 seconds massage the injection
site for 10 seconds
• Palpitations
• Nausea and vomiting
• Headaches
• Dizziness
• Cold sweat
• Fatigue
• Difficulty in breathing

The list of side effects is printed on the manufacturer's documentation.

Most side effects will subside after several minutes of rest.
Questions?