When “Harmless” Substances Can Kill

By Paula L. Mueller, RN, NCSN

Anaphylaxis is the body’s overreaction to a generally harmless substance, which can have serious consequences if not treated promptly (a severe allergic reaction). Most often the “harmful” substance is a medication, food, or venom from a stinging insect. The most common food allergens are peanuts, nuts, milk, egg, soy, fish, and shellfish.

After exposure to the substance perceived as harmful, the body releases many chemicals that cause the symptoms of the anaphylactic reaction. Typical symptoms are:

• Tingling in mouth
• Swelling of tongue, throat, and around eyes
• Difficulty breathing
• Hives
• Vomiting, abdominal cramps, diarrhea
• Drop in blood pressure
• Loss of consciousness

If not treated the symptoms may progress to death- seconds truly DO count.

Treatment of choice for an anaphylactic reaction is epinephrine. This medication is commonly packaged in a prefilled, automatically injected syringe known as an Epipen or Epipen Jr.

The first line of treatment for a severe allergy though, should always be prevention. Avoid exposure to the offending substance if at all possible.

Usually, when a person is initially diagnosed with such a severe allergy, he/she is very vigilant about avoidance of the allergen and carrying an Epipen in case of a reaction. Unfortunately, as time passes, it is human nature to become less and less careful. People tend to feel that since a reaction hasn’t occurred in a while it might not happen again. When dealing with anaphylaxis continued vigilance must be the rule. A person known to have this severe allergy should have an Epipen available at all times and should try to avoid exposure to the harmful substance.

It is very important in the school setting for the nurse and the student’s teachers to be aware of the substance the student is allergic to, particularly if it is a something common such as peanuts, nuts, eggs, wheat, or milk. Disclosure of this information will allow the staff members to assist the student to avoid the allergen, and provide for prompt treatment upon exposure. Students who have a diagnosis of anaphylaxis should have their physician’s order forms, parental permission forms, and medication available on the first day of school. Provisions should be made for the medication to go on all field trips with the student and the medication should not be brought home from school until the very last day of school in the spring.

Approximately 1-2% of the population is at risk for anaphylaxis. Creation of peanut-free zones, peanut-free airline flights, and posting of peanut warning signs in food vending areas are all positive signs that awareness about this life-threatening problem is increasing

If anybody would like to learn more about anaphylaxis, Apponequet High School has an excellent video available for your viewing. Please call 947-2660 ext. 157 to ask any questions or watch the video.