When diagnosed allergy with risk of anaphylactic reaction it is primary
important to know what caused the anaphylactic reaction. This MUST be
determent by your physician or specialist because otherwise
unnecessary social and nutritional restrictions (when food allergy is
the cause) might be imposed. This is not desirable for the patient and
might be harmful, especially with children, but also for the entourage
of the patient is it desirable to know because otherwise unreasonable
demands might be imposed.
Avoidance of the
allergen as to prevent exposure to the patient.
Elimination diet All foods causing complaints are to be avoided. Important is that some
products which are not tolerated in fresh state, like vegetables and fruit,
often are being tolerated when processed, because the allergens in
question are not able to resist heat. (thermo
unstable). In such a case it will be sufficient
to avoid raw products.
Also important is to insure that only these foods are being avoided which
cause genuine complaints. It is not useful to eliminate the whole group of
foods. Example when allergic to peanut it is not common to avoid also
other peas as those probably will not cause any complaints. This unlike
the outcome of allergy testing giving sometimes positive reactions to
these foods.
Patients at risk of severe reactions stringent vigilance and elimination
of the appropriate foods MUST take place. This means that also small
amounts (traces) of the suspected food MUST BE AVOIDED. As it could be the
case that some allergens are hidden in certain products, the patient
should be informed. In this way traces of peanut might occur in
products less expected like soup, sauce, cookies and cakes, Oriental
dishes and popsicles!
Often patients are being advised to use socalled "brand lists" Lists
of product free from a certain allergen. In the Netherlands these lists
(in Dutch) are being distributed by the Voedingscentrum (
www.voedingscentrum.nl ). In daily practice it is reality that allergic
reactions are not always avoidable. Often due to hidden allergens of
inadequate insights of the problematic nature.
In this view Children's parties and stay & sleep parties are notorious.
Even going on holidays abroad give cause to problems for instance by a
different way of labelling of foods.
This is why it is NEEDED to give advise to patients at risk of the more
severe reactions (anaphylactic shock or Glottis Edema) on medical
intervention. This way they know how to manage and cope when a severe
reaction occurs.
With every dietary advise it is important that the diet is adequate and if
the propsed diet is also realizable for that patient.
In the rare event that (temporarily) the proposed diet is not realizable
addition of supplement for instance calcium and vitamins are appropriate.
When No. 1 can't be
met a highly effective rescue aid is available against Anaphylaxis. GIVE ADRENALINE. (EPINEPHRINE) AND CALL AN AMBULANCE IMMEDIATELY!!
In the Netherlands call 112 and ask for an Ambulance. Tell them it is for
an anaphylactic shock reaction.
When the ambulance arrives tell them you have given epinephrine through
the EpiPen®. Give the EpiPen® to the ambulance personnel.
When you have given other medication tell this also to the ambulance
personnel.
The Ambulance personnel will take all the necessary steps to safe guard
the patient.
The patient will be transported to the hospital where he will be observed
for a minimum of 8 hours and in some cases for 24 hours.
In the Netherlands when diagnosed anaphylactic, the doctor can and
should prescribe an adrenaline auto-injector
(EpiPen®).
Be sure to apply the first AID rules and warn others to get help.
