An allergic reaction is למעשה a "malfunction" in the immune system, which identifies an innocent protein (like the one in peanuts) as a cruel enemy and launches an all-out war. In mild cases this ends with a rash and itching. In severe cases, anaphylactic shock develops: The blood vessels expand at once (drop in blood pressure), and the airways contract and swell to the point of suffocation. Death can occur within minutes.
The only medication that can reverse the situation in the field is adrenaline (epinephrine). It constricts the blood vessels, expands the airways and restores the body to function. It is contained within an auto-injector (such as Epipen or Jext) designed for use by people without a medical background.
How do you identify a life-threatening attack?
If you have been exposed to an allergen or stung, look for the following signs. The appearance of two symptoms in two or more body systems (for example skin and breathing) indicates anaphylaxis:
- Skin: A red and itchy rash (urticaria), swelling in the lips, eyes or tongue.
- Breathing: Difficulty breathing, wheezing, a barking cough, sudden hoarseness ("choking in the throat").
- Digestion: Severe abdominal pain, repeated vomiting, diarrhea.
- Circulatory system: Dizziness, fainting, paleness or bluish discoloration.
The guide to injecting Epipen (auto-injector)
If there is suspicion of anaphylaxis, do not wait. The danger from adrenaline is negligible compared to the danger of death from suffocation. In doubt? Inject. At the same time, ask someone to dial 101 for MDA, put it on speaker.
Preparing the injector
Remove the injector from the packaging. Hold it in a firm fist (like holding a bicycle handle) to avoid accidentally injecting into the thumb. Remove the blue safety cap (in most injectors it is at the back). Remember the phrase: "Blue to the sky, orange to the leg" (the orange side is the side from which the needle comes out).
The injection
Aim the orange side at the outer part of the thigh (quadriceps muscle). There is no need to remove pants – the injector penetrates even jeans. Thrust the injector into the thigh in a sharp motion and at a 90-degree angle, until you hear a "click". Hold the injector in place for 3–10 seconds (depending on the type of injector, it is better to hold for 10 to be safe) to ensure all the medication enters.
After the injection
Remove the injector carefully. The needle will now be covered (in most models). Massage the injection site for about 10 seconds to improve absorption. Hand the used injector to the ambulance team that arrives.
Important to know: The effect of adrenaline is short-lived (about 15–20 minutes). Sometimes there is a "rebound" effect and the attack returns, therefore even if the casualty feels excellent after the injection, evacuation to the hospital for observation is mandatory.
In any case of an emergency, call MDA at 101, provide accurate address details, keep the dispatcher on speaker and act according to their instructions.