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Anaphylaxis or Anaphylactic Shock

Anaphylaxis is at the extreme end of the allergy spectrum. It's frightening, there's no questioning this. Frightening for the sufferer and those around him or her.

Anaphylaxis is to allergy what parachuting on a surfboard is to extreme sports. It's life threatening, but without the pleasurable buzz. Yes, it could be a foreign spy, but is better described as a lethal assassin. The weapon can be one of a number of different innocuous substances, and when they strike, speed is of the essence.

There's nothing funny about someone's face, lips, tongue and throat swelling so much that they can't speak or breathe. The whole body can be affected, sometimes within hours of exposure to the allergen, often within just minutes. The skin may flush, hives (like nettle rash) may appear anywhere on the body, abdominal cramping, pain and diarrhoea may occur, the person may describe a sense of impending doom and have difficulty speaking, swallowing and breathing because everything is becoming swollen, or they may feel faint and weak because their blood pressure is falling. But don't expect all these symptoms to occur because they may not. The bottom line is that any of these symptoms needs attention, and quickly.

Certain foods (e.g. peanuts, shellfish, dairy products), latex, drugs, and insect bites and stings are the usual suspects. Restaurant and food manufacturers are now very keen to inform people about what's in their foods to protect allergic individuals from problems and to protect themselves from litigation. Any food can be responsible, but it's peanuts, tree nuts (walnuts, cashews, etc.), fish, shellfish, eggs and milk that commonly cause anaphylactic reactions, and for some people only a trace is needed to set the reaction off.

Doctors too are very keen to know whether you have any allergies to particular substances, in particular to drugs like penicillin. So if you do have an allergy, particularly a severe one, don't hesitate to tell your doctor or nurse because, you never know, it may not be logged in your medical records. Who do you spend most time with? Hopefully it's your family and friends, so make sure they know about your allergy too. And don't forget your work colleagues. You see, prevention really is better than cure, and when they make you a surprise birthday cake, if it contains something you're allergic to it may as well be laced with poison, particularly if they don't know what to do when you start to inflate like a balloon.

Of course, it's best to avoid the triggers if you can. But how many times have you been stung by an insect because you wanted to be? How many times have you said, 'it's OK doc, I know I'm allergic to penicillin but what the heck, give it to me anyway'? Hopefully the answer is zero, nil, nada. No one wants to suffer anaphylaxis, but it can and does happen despite someone's best efforts to avoid it.

This is where it's time to make like a Cub Scout and be prepared. Those people who are known to be at risk of suffering anaphylaxis are advised to wear a Medic-Alert talisman or similar bracelet or necklace stating their allergy, so that if they should be found unconscious it's clear what action needs taking. Those at risk are also advised to carry preloaded adrenaline (epinephrine) injection kits with them and, most importantly, to learn how to use them correctly. Those around them should also know how to use these essential injections, because you never know when you are going to need to give the injection that could save your friend's life. And while we're on the subject, knowledge of basic first aid and resuscitation is never wasted either.


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