A Field Medic's Guide to First Aid

(Work in progress.)

Anaphylaxis (Allergic Reaction)
Anaphylaxis, or anaphylactic shock, is a life-threatening allergic reaction that occurs within moments to minutes after exposure to the allergen. It is caused by an overreaction in the immune system, which floods the bloodstream with chemicals that cause the sufferer to experience a sudden drop in blood pressure, followed by a constriction in the airways that causes difficulty breathing.

Symptoms

 * Hypotension (low blood pressure)
 * Epidermal reactions (itching, inflammation, hives, flushed or pale skin)
 * Swollen tongue or throat
 * Constricted airways (can cause wheezing, gasping, trouble breathing)
 * Weak and rapid pulse
 * Nausea, vomitus, diarrhea
 * Dizziness, light-headedness, fainting

Risk Factors

 * Seasonal allergies or asthma: Those who have either of these conditions are at increased risk of having anaphylaxis.
 * Other conditions: There are other separate instances in which anaphylaxis can occur. Heart disease, mastocytosis, aerobic exercise such as walking or running, eating certain foods before exercise and exercising when the weather is hot, cold or humid have all been known to manifest anaphylaxis.

Diagnostics
When attempting to diagnose a patient with Anaphylaxis, we must first discover if they have any past experiences with allergic reactions of any level. Common reaction-inducing allergens include:
 * Particular foods, such as peanuts, almonds, eggs, milk, wheat, etc.
 * Medications
 * Rubber, vinyl
 * Insect stings

If we are able to identify a possible allergen, we may proceed to certain testing to confirm the diagnosis. The Tryptase Test is a blood test that measures the presence of tryptase — an enzyme that is often increased in production following anaphylaxis. There are also many other blood and skin tests that you will use to predict the patient's trigger allergen.

Emergency Treatment
When dealing with an anaphylactic episode, always keep in mind that at any point during treatment, you may be required to perform cardiopulmonary resuscitation, or CPR. While it is our duty to try our hardest to keep such things from coming to pass, it is still important to be mentally and physically prepared for anything.

If the patient is breathing, we must begin treatment by administering Epinephrine — or adrenaline — to reduce the intensity of their allergic response. 0.1mg/mL is the dosage level that is widely accepted as treatment for adults. This will usually be administered once every 10-15 minutes.

If the patient has gone into cardiac arrest, the dosage level is increased. 1mg/mL is what is initially administered; dosages above this have not been shown to definitively improve survival, or neurological outcomes as compared to standard dosing. Therefore, it is not recommended.

If you have access to hospital care supplies such as masks and IVs, provide Oxygen in the form of a mask to help the patient breathe, and support their breathing until they are able to do so unimpeded. Intravenous (IV) antihistamines and cortisone should be established and functioning while you are administering oxygen.

Should the patient still have difficulty breathing on their own, you may administer light doses of Swiftthistle to relieve breathing complications. Top