Allergy Emergency

Allergies are increasing over the past three decades. But beyond runny noses or unsightly hives, allergies can sometimes require care in an emergency. Learn how to react!

Allergies are not always taken lightly! In the United States, each year there are 10 to 20 severe reactions per 100 000 inhabitants and 1 to 3 deaths per million inhabitants1. Since 1990, hospital admissions for anaphylaxis in England increased by 700% for food allergy by 500% to 100% of hives and swelling by 40%2. Specialists are the point at the salon medicine3 MEDEC 2007 on allergies emergency treatment.

Hives often banal

Allergy skin is the most banal urticariaThat many of us have already encountered after consuming shellfish, fish or strawberries ... The skin reddens and swells in places and is subject to very severe itching. If the urticaria is not associated with signs of severity (edema, difficulty breathing ...), the first step is to remove the allergenic substance and act quickly on the redness and swelling of the skin through the Terminal antihistamines. This medication is usually sufficient to calm the symptoms. Where appropriate, corticosteroids may possibly occur in the second line by removing the ignition. But their side effects limit their use over the long term.

Attention all hives are not allergic, some are caused by infectious, physical (excessive heat, sun, clothes too tight or irritating ...) or more rarely linked to contact with caterpillars.

The dangerous swelling of the larynx

Edema reflects the infiltration of fluid in the tissues of the face with severe itching in an allergic reaction (hives). Its danger is directly linked to its location. On the skin it will inconvenience a major embarrassment unsightly, but it is located in the larynx (between the throat and trachea), it can restrict breathing and life-threatening. A dystonia (and painful involuntary contraction), hyper-salivation and swallowing problems are alert. In this case, the ambulance must be called urgently. In the interim his arrival, treatment Antihistamines, corticosteroids may be supplemented by salbutamol to calm bronchospasm and injection ofadrenalineVia syringe ready for use.

In very rare cases, swelling is not allergic, but is linked to a rare disease of genetic origin. Do not respond to treatments for allergies, these edemas based on the danazol and thetranexamic acid; C1INH concentrate (product of blood) is reserved for very serious crisis4. Most of the time these events regress in two days.

Bronchospasm, not overlooked!

Asthma is an allergic disease in many cases, nearly 99% in children. In case of inhalation of allergen, the child may suffer an involuntary contraction of the airways which will restrict the breathing, speaking of bronchospasm. The allergen is usually identified (the smell is on the track, or triggers crisis are already known). But this is not always the case. Warning, these allergic events are not trivial and still are the cause of death. Treatment depends on decision bronchodilating beta2 stimulants administered by inhalation. These drugs allow a relaxation of the bronchial muscles and thereby relieving. Adrenaline injection is an option not to be overlooked. If the crisis is not relieved, it should call the EMS for medical care quickly.

Anaphylactic shock: a vital emergency

The anaphylactic shock is the most dangerous manifestation of allergy. Classified according to severity (grade I events limited to the skin and mucous membranes to grade IV characterized by cardiac arrest)5It is primarily to food, drugs or insect venom. It is a life-threatening emergency! Injection adrenaline is the first treatment, she may be supplemented by corticosteroids (in case of angioedema associated), but their onset of action are relegated to second place. The use of EMS and hospital care is necessary even in cases of improvement noted. There is a risk of "rebound" of anaphylaxis, only one hospital surveillance can effectively handle.