It was about 3:00am (some 17 yrs ago) and I was asleep on the uncomfortable cot at my ambulance resting quarters. It had been a long day of calls and we had taken advantage of the short reprieve to get a little rest. We were woken by that all too familiar buzzing of pagers and alarms letting us know that our rest was over. We quickly jumped into the now very cold ambulance rubbing our hands together. Our breath visible in the cold. My partner got the ambulance moving as I read the call aloud still feeling that adrenaline rush of being awoken from a dead sleep. The call was for a man suffering from a swollen cheek. When we arrived on scene we found the man as described, cheek swollen but alert and in no obvious distress. We began the usual investigative questioning searching for a reason for his current state of a puffy cheek. We were told he had been suffering from an infection and was at the hospital earlier that day because his other cheek was swollen. They treated him at the hospital and the swelling went down and he was sent home with antibiotics and was told he had some sort of infection. We assumed that this infection was probably the cause of his current swelling. We took his vital signs. Everything was normal. No other signs of swelling. He was breathing normally and his oxygen level was 100%. We put him on oxygen anyway just as a precaution. We repeatedly asked him if he was having any trouble breathing and he would always shake his head no. We informed him that we would be taking him to the hospital just to be on the safe side and loaded him up onto the gurney. I remember looking him in the eye, putting my hand on his and telling him that if he had any trouble breathing to put his hand up and let us know. He gave me a thumbs up and out the door we went, loading him into the ambulance. The hospital was pretty close, maybe 10 minutes away. I was driving. It should have been a quick and easy call but it would end completely differently. What happened next was a dramatic change in his presentation, literally within minutes. He went from being alert and breathing with no trouble to serious respiratory distress. I remember looking behind me at the sudden chaos and panic as my partner began trying to get an airway in him, calling his name. I remember driving as fast as I could, lights on and siren blaring as I spoke to the hospital on the intercom. I remember saying, "starting CPR". We rolled the gurney into the emergency room pounding on his chest and pushing breathes that would not go in with a bag mask. In the first bay of the ER, we all flew around the room as the Doctor on duty tried repeatedly to get a tube down the man's throat with no luck and eventually slicing his throat in a last ditch effort to get air. Everything was tried including repeated medications but it was already to late. The man died right there in the ER. This was the same man who no less then 10 minutes before smiled at me with a thumbs up sign. So what happened and how did it happen so quick? This man did have an infection, but he also suffered an allergic reaction to the antibiotics given to him. A reaction so severe that it took him from talking to dead within 20 minutes. He did not know he was allergic and neither did we. As with any ambulance call where the outcome is bad, we beat ourselves up questioning what could have been done differently. I still think of this man sometimes.
This was not my only experience with the unpredictability of severe allergic reactions (Anaphylaxis). I had seen my mother suffer from them and I too have had my own trips in the ambulance for this very reason. I carry my epinephrine with me at all times and wear an alert bracelet as well. I know that horrible feeling of impending doom all too well; when you feel like your ability to breathe is about to be taken away.
Anaphylactic Reactions are nothing to joke about. They can be deadly and they do kill people. Below are 10 tips I have to help others to stay informed on this serious topic. Also, we offer Anaphylactic reaction information and epinephrine injector training as part of all of our CPR and First Aid course options. We also offer this training free of charge at our facility as well. Please visit our website for more information or feel free to contact us. (www.lifefirsttrainingcenter.com)
1. If you've had a severe allergic reaction in the past, make sure you always carry an epinephrine injecting device with you at all times.
2. There are a variety of different epinephrine injection devices on the market and there are options available to help cover the cost of these injectors as well. We encourage you to discuss all options with your physician. For more information please contact our training center.
3. If you or someone you know has had a severe allergic reaction in the past, make sure that friends and family know how to use their epinephrine injecting device. Injector trainers usually come with the device but may also be requested from the manufacturer. We also provide this training through our training center free of charge.
4. Keep your epinephrine injector at room temperature and out of the heat. Keep an eye out for the expiration date. Replace your device when expiring. Also keep your medical history, allergies and prescription medication information easily accessible in case of an emergency. We do supply both allergy and medical information wallet cards free of charge through our training center.
5. If you or someone you care about has suffered a severe allergic reaction in the past, make sure to be a strong advocate/detective. Keep an eye out for possible situations where the individual may come into contact with what their allergic reaction was to. Do not be afraid to speak up. For example, if you are allergic to latex make sure to mention this to all dental and medical providers and be aware that sometimes restaurants staff use latex gloves when handling food. If you're allergic to a certain food product, make sure you mention it to your waiter at every restaurant even if you're not ordering something that has that product in it.
6. You may not know that you're allergic to something if this is your first reaction. If somebody has a severe allergic reaction, it is possible that there may not be an epinephrine injecting device available. If this is the case, please make sure to call 911 immediately if you notice signs of a possible Anaphylactic reaction. Also, try your best to keep the person as calm as possible. Be prepared to start CPR if needed. Signs of a possible Anaphylactic reaction include swelling and/tingling around the face, mouth, tongue, lips or inside the throat. A rash may be present but that is not always the case. If someone complains of these symptoms, especially if it's shortly after eating food, taking medication or being stung by an insect, assume it is it possible allergic reaction and call 911 immediately.
7. Get informed on the current laws in your state regarding the use of epinephrine injectors in schools and businesses. In the state of California, schools and even some businesses are now able to keep epinephrine injectors on site to be used on anyone who shows symptoms of a severe allergic reaction.
8. If you work in the medical field or another industry where you may come in contact with possible life-threatening Allergy triggers such as latex, please take these allergies seriously. If a patient tells you they're allergic to latex gloves, make sure there are no latex gloves anywhere around them. Do not touch them with gloves even for a second. If a patient tells you they are allergic to latex or it is in their file and you use gloves on them anyway, you can be held liable and you're putting that person's life at risk. Educate the other staff in your facility in regards to the serious nature of Anaphylactic reactions as well.
9. Take a First Aid and CPR training course every two years so you are prepared when an emergency such as a severe allergic reaction occurs. Please see our website for upcoming course dates and times.
10. Educate others. There are still far too many people in this world who know nothing about Anaphylactic reactions and just how serious they can be. Now that you have this information, please share it with others. The more people that are educated on Anaphylactic emergencies, the more lives will be saved.