If you are of a certain age, you remember when peanuts were served on airlines. Rarely are peanuts passed freely now. We all know why; certain people have an allergy to peanuts. As a friend of my youngest son had a severe peanut allergy, I witnessed first hand how it impacts upon life and simply going to a college football game.
But not all allergic reactions are to peanuts. Another common reaction is to bee stings. My mother had progressively worse reactions to bee stings, the last sending her to the emergency room.
But what happens when there is no emergency room nearby? How often does it occur, and what are the treatment options?
The medical term for the above is Anaphylaxis. It is a potential life threatening allergic reaction. Exposure to an molecule, for example the peanuts, causes the body’s immune system to release a large amount of chemicals. These chemicals can cause:
Skin reaction, hives
Low blood pressure
Nausea, vomiting, diarrhea
Difficulty breathing due to constriction of the airway
It is estimated that 1.6 – 2.0% of the US population is at risk of developing an anaphylactic reaction. There are two groups which have reported on the incidence of anaphylaxis in the outdoor setting. National Outdoor Leadership School and Outward Bound. The incidence of anaphylaxis appeared in 0.01% student in Outward Bound, and 0.03% in National Outdoor Leadership School. Rare but life threatening. Neither organization reported deaths. National Outdoor Leadership School reported 21% cases were in people with no prior history of allergy.
Three main causes of the allergic reaction were noted. Insect bites occurred in 33-43% of the cases. Peanut or tree nuts caused 15-33% of the cases. Fully 8-20% cases occurred in individuals that had no prior history of allergic reaction.
The treatment is epinephrine. Both organizations noted above supplies its groups with epinephrine, and this may account for absence of fatalities.
Epinephrine is available in prefilled syringes, the Epi Pen being one brand.
There are other supplemental treatments that can reduce the anaphylactic reaction including antihistamines, inhalers, and steroids. However, the first line treatment remains epinephrine and additional doses of epinephrine.
An amazing story was published in 2012. Twenty six people were in a remote area of Costa Rica for the Expedition Medicine Jungle Course. Two physicians were part of the group. A fit and healthy woman was stung by wasps while attempting to retrieve water. Extraction to a medical facility took nearly 7 hours, multiple doses of epinephrine (seven doses in total), and multiple modes of transportation. The story details the patient condition during the extraction, and it is readily apparent that the outcome could have been different.
If you are of a certain age, you remember when peanuts were served on airlines. Rarely are peanuts passed freely now. We all know why; certain people have an allergy to peanuts.
Cuts and abrasions happen in the outdoors. It is as simple as being in an uncontrolled environment. Uneven ground. Pushing our limits. Knifes that are not quite sharp.
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