The unusual ‘sense of doom’ symptom that signals an allergy emergency

Original article here

An allergy specialist has issued advice about the early warning signs of a severe allergic reaction. They also highlighted the critical timeframe that everyone needs to be aware of should a reaction occur.

Around 21 million people across the UK live with an allergic condition, according to statistics provided by Allergy UK. Hay fever alone impacts 16 million people, whereas 2.4 million adults suffer from food allergies.

Reactions can range from minor rashes to life-threatening symptoms like breathing difficulties and loss of consciousness. Hannah Kramer, clinical nurse specialist, cautions that reactions can trigger rapidly and has outlined the steps people should take.

MORE ON HEALTH

• You might be able to get a free flu jab – even if you’re healthy and under 65
• Meningitis jab uptake ‘too low’ as experts warn more outbreaks possible

“When someone has an immediate food allergy, the reaction typically begins within seconds or minutes of exposure to the food, and within a two-hour window from there. Interestingly, people having anaphylaxis often describe ‘an impending sense of doom’, a sense of panic and fear in response to their physical bodily symptoms,” says Kramer, from The Allergy Centre of Excellence.

“The important thing is that anaphylaxis can begin with quite subtle symptoms, such as, for example, that tickly cough that isn’t going away and wasn’t there before. Many people think that anaphylaxis is dramatic and obvious, which of course it can be, but not always.”

Kramer explains that the necessary intervention depends on the severity of the symptoms, with acute cases requiring emergency medical care. She notes that certain severe situations demand immediate administration of adrenaline, which is an injectable medication provided to individuals with known conditions, writes Elaine Blackburne for the Mirror.

What is anaphylaxis?

Anaphylaxis is an allergic reaction that affects a person’s airway, breathing, or circulation. The NHS explains: “Anaphylaxis is a life-threatening allergic reaction that happens very quickly. It can be caused by food, medicine or insect stings. Call 999 if you think you or someone else is having an anaphylactic reaction.”

Hannah outlines the core warning signs of an allergic attack.

• A: Starting at the top of the body, we have the airway – a person could develop tongue swelling or throat tightening. Throat tightening can present as a hoarse voice or cry, difficulty swallowing, or a persistent tickly throat-clearing cough
• B: Down in the lungs, you could hear a wheeze or a tight cough. The person may be having difficulty breathing, breathing faster, or harder than usual
• C: Circulation, during a severe allergic reaction, blood pressure can drop quite suddenly, so the person may become pale, drowsy, dizzy, confused, or fall unconscious.

Mild symptoms to watch for

Symptoms of a typical (mild) reaction might include:

• Facial swelling
• Itching in or around the mouth
• Itchy hives appearing
• Nausea
• Skin rashes
• Sneezing or a suddenly runny nose
• Vomiting

Hannah says: “These symptoms would be treated with a dose of antihistamine (either liquid or tablet form). However, mild symptoms can sometimes very quickly progress into severe life-threatening symptoms.”

Severe life-threatening symptoms

Examples of severe life-threatening symptoms might include:

• Becoming pale
• Breathing difficulties
• Dizziness
• Falling unconscious
• Throat swelling (characterised by a tickly cough, change in voice, or difficulty swallowing)
• Tongue swelling
• Wheezing

Kramer warns: “Any one of these symptoms alone is reason enough to use adrenaline (either via injection into the thigh, or with a nasal adrenaline spray). The most important thing we can teach our families is that if in doubt about what to do, and you think the person is showing any one of the symptoms we just mentioned, give adrenaline.

“It is a very safe medication that wears off within minutes; no harm will be done if you’re wrong. But the longer you wait to give adrenaline, the worse and more dangerous the outcomes could be.”

The NHS also provides guidance for those experiencing a sudden anaphylactic reaction, including when to dial 999. It states: “Call 999 if:

• A child is limp, floppy or not responding like they normally do (their head may fall to the side, backwards or forwards, or they may find it difficult to lift their head or focus on your face)
• Someone faints and cannot be woken up
• You suddenly become very confused, drowsy or dizzy
• Your lips, mouth, throat or tongue suddenly become swollen
• Your skin, tongue or lips turn blue, grey or pale (if you have black or brown skin, this may be easier to see on the palms of your hands or soles of your feet)
• Your throat feels tight or you’re struggling to swallow
• You’re breathing very fast or struggling to breathe (you may become very wheezy or feel like you’re choking or gasping for air)

“You or the person who’s unwell may also have a rash that’s swollen, raised or itchy. These can be signs of a serious allergic reaction and may need immediate treatment in hospital.”

It advises that if you believe you or someone nearby is suffering an anaphylactic reaction:

• Use an adrenaline auto-injector (such as an EpiPen) if you have one – instructions are included on the side of the injector.
• Call 999 for an ambulance and say that you think you’re having an anaphylactic reaction.
• Lie down – you can raise your legs, and if you’re struggling to breathe, raise your shoulders or sit up slowly (if you’re pregnant, lie on your left side).
• If you have been stung by an insect, try to remove the sting if it’s still in the skin.
• If your symptoms have not improved after five minutes, use a second adrenaline auto-injector.

It further adds: “Do not stand or walk at any time, even if you feel better.”