Anaphylaxis is a severe and potentially life-threatening immune response that causes a flood of hormones to be released by the body, which results in a dangerous drop in blood pressure, narrowing of blood vessels, swelling of the esophagus, which can restrict breathing, rashes, and redness of the skin, according to the Mayo Clinic.
To counteract this reaction, the person would need an emergency medication administration of a hormone called epinephrine, says Waqas Mahmood, MD, a physician at the Hospital of The University of Pennsylvania. This hormone can halt anaphylactic shock by relaxing the muscles in your throat and airways to help you breathe, reverse plummeting heart rate and blood pressure, and relax the muscles in your stomach, central organs, and bladder. It typically comes in something called an EpiPen.
You have likely heard about epinephrine by its other, more well known, name adrenaline, says Dr. Mahmood. An EpiPen is essentially a shot of adrenaline that can, and has, saved lives during anaphylaxis. Because your blood pressure drops, blood vessels narrow, and muscles stiffen, it makes all important processes like breathing and getting oxygen to your body harder to execute. This is why it's essential to dose someone experiencing anaphylaxis with epinephrine.
Symptoms of anaphylaxis, according to the National Library of Medicine, include difficulty breathing, wheezing, sneezing, hives, itching, swelling, skin redness, rapid heartbeat, weak pulse, anxiety, confusion, stomach pain, losing control of urine or bowel movement and fainting. People with known severe allergies should seek medical treatment if they know they've come into contact with the substance and always keep their EpiPen accessible.
How to use an EpiPen
In case you were curious, here are the three important but simple steps to using an EpiPen, according to Dr. Mahmood. It's important to move calmly and quickly during a situation like this, he says, because the person reacting needs the dose as quickly and correctly as possible.
Step 1: Remove the EpiPen from the case, and read the instructions
Once you have identified that you or someone you're with is having a reaction that requires an EpiPen dose, acquire an unused EpiPen, remove it from its case, and have the person experiencing the reaction sit down somewhere so that they don't risk falling or fainting, says Dr. Mahmood.
Step 2: Administer the dose
Every EpiPen will have instructions for administering the dose in case people don't know or don't remember. The three steps for administering the dose, as outlined on the side of the EpiPen FDA fact sheet, are as follows:
- Remove the blue safety lid from the top. Some people use the phrase, sky blue to remember that the blue side is the top)
- Make a fist around the EpiPen with the orange-colored needle end, and firmly press the needle into the side of the outer thigh. If you have time, you should expose the person's bare thigh, but if not, EpiPen's instructions indicate that the dose can go through clothing.
- Hold for 10 seconds, counting out loud.
- Pull the pen away and massage the area for 10 seconds. Do not throw away the pen. Bring it to medical providers so that they know how much epinephrine was dosed at the time of EpiPen administration.
Step 3: Seek emergency care ASAP
Call 911 or seek the fastest possible emergency medical care, the instructions and Dr. Mahmood stress. An EpiPen dose does not treat an allergic reaction; it only stops the onset of anaphylaxis. This means that the person receiving the dose needs more medical treatment to stop the allergic reaction in its entirety.
Other things to consider when using an EpiPen
All EpiPens have a blue top and an orange bottom, as mentioned above. Never put your finger over the needle end and if you are accidentally injected—seek emergency medical treatment because epinephrine can be life-threatening in the absence of anaphylaxis.
Epipens are somewhat notoriously expensive (coming in at around $700 for one pen), but in 2018 a generic version of the medication, called Adrenaclick, was released and can be purchased for around $130 for a pack of 2 injectors.
Allergies are different for everyone, so those with severe allergies should make sure they talk to their providers about their symptoms to be better prepared in an emergency.
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