Asthma & Anaphylaxis Emergency in the Home

Epipen – an easy to use adrenaline auto-injector

If asthma or anaphylaxis are very real threats to you, a family member, or a friend, it is important that both you and your home are prepared.

In order to be ready for an asthma or anaphylaxis emergency you should follow 3 steps:

1. Reduce the risk of an emergency by removing triggers
2. Know the symptoms so you can act quickly
3. Know how to react in the event of an emergency

Be ready for anaphylactic and asthma emergency

1. Know the triggers

The factors that cause someone to have an anaphylactic or asthmatic reaction are called ‘allergens’ or ‘triggers’.

For someone with anaphylaxis or asthma, it's critical that trigger substances be removed from the immediate environment to reduce the risk of anaphylaxis or an asthma attack.

In order to ‘trigger proof’ your home, you first need to know what the triggers are.

Triggers vary from person to person. You'll need to know what would cause the individual in question to react adversely. You will need to ask the person if this is new territory for you.

The lists below include the more common triggers that cause anaphylaxis  and asthma attacks:

Anaphylaxis:

• Food
• Milk
• Eggs
• Peanuts
• Tree nuts
• Sesame
• Fish
• Shellfish
• Wheat
• Soy

Venom from Bites and Stings

• Bee
• Wasp
• Ant stings

Medications

• Over the counter
• Prescribed
• Herbal/alternative

Asthma

• Cigarette smoke
• Exercise
• Inhaled allergens (e.g. pollens, moulds, animal dander and dust mites)
• Environmental factors (e.g. dust, pollution, wood smoke, bush fires)
• Chemicals and strong smells (e.g. perfumes, cleaning products)
• Some foods and food preservatives, flavourings and colourings (uncommon)

Other triggers for asthmatics:

• Colds and flu
• Certain medications
• Emotional factors (e.g. laughter and stress)
• Changes in temperature and weather

2. Know the symptoms

So you can act fast in an asthma or anaphylactic emergency in the home, the next step is to know the symptoms.

Anaphylaxis symptoms include:

• Tightness of the throat from swelling
• Difficulty breathing
• Tongue & facial swelling
• Hoarse voice or difficulty speaking
• A wheeze or persistent cough
• Collapse or falling unconscious
• Becoming pale or floppy (young children)
• Abdominal pain & vomiting
• Hives, welts & body redness

The most common asthma symptoms include:

• Wheezing
• Shortness of breath
• Chest tightness
• Coughing fits
• Difficulty breathing
• Dry, irritating, persistent cough, particularly at night and early morning

Asthma danger signs

Symptoms of a severe asthma attack include:

• Gasping for breath, having little or no wheeze due to lack of air movement
• Severe difficulties breathing
• Severe chest tightness
• Only able to speak a few words at a time
• Feeling distressed and anxious
• Blue discolouration on or around the lips (if skin colour also changes this can be hard to see)
• Pale and sweaty skin
• Sucking in of throat and rib muscles
• Using shoulder muscles or bracing with arms to help with breathing
• Symptoms rapidly getting worse or frequently using reliever more than every 2 hours
• Children may become restless, unable to to settle or become drowsy
• Children may also have trouble eating and drinking due to shortness of breath
• A child may have severe coughing or vomiting

3. Know how to react

No matter how well you trigger proof your home, in sensitive cases, it takes just a small amount of the allergen to set off an attack.

For that reason, make sure you know how to react to an anaphylaxis and asthma emergency in your home.

First Aid for Anaphylaxis

• Lay victim flat, do not stand or walk, if breathing is difficult, allow to sit
• Prevent further exposure to the triggering agent if possible
• Administer adrenaline through auto-injector:
  • Child less than 5 years - 0.15 mg intramuscular injection.
  • Older than 5 years - 0.3mg intramuscular injection

• Call an ambulance
• Administer oxygen and / or asthma medication for respiratory symptoms.
• Further adrenaline should be given if no response after five minutes.
• If breathing stops follow basic life support procedures.

First Aid for Asthma

• Without delay give 4 separate puffs of a “reliever”. The medication is best given one puff at a time via a spacer device. If a spacer is not available, simply use the puffer.
• Ask the person to take 4 breaths from the spacer after each puff of medication.
• Use the victim’s own inhaler if possible. If not, use the first aid kit inhaler if available, or borrow one from someone else.
• The first aid rescuer should provide assistance with administration of a reliever if required.

Step 3:

• Wait 4 minutes. If there is little or no improvement give another 4 puffs.

Step 4:

• If there is still no improvement, call an ambulance immediately. Keep giving 4 puffs every 4 minutes until the ambulance arrives.

For more information about anaphylaxis read Guideline 9.2.7 by Australian Resuscitation Council.

To learn more about first aid management for asthma, read Guideline 9.2.5 by Australian Resuscitation Council and New Zealand Resuscitation Council.