Category Archives: Anaphylactic Reaction

Injecting Antihistamines: The Benefits and Proper Administration

Posted on September 5, 2011 by Admin

Dr. Johnson discusses the benefits of antihistamines and the proper administration considering a swollen airway. Continue reading →

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Q: Do you have a protocol for administering epinephrine in vials?

Posted on August 30, 2011 by David Johnson, MD

Creating protocols for administering epinephrine in vials and things to consider. Continue reading →

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Q: Can a group of field researchers trained in basic first aid be permitted to have an epipen in a first aid kit?

Posted on February 15, 2011 by David Johnson, MD

Q: Can a group of field researchers, certified in basic first aid, be allowed to have an epipen in a first aid kit at the location. There are no individuals with known allergies or prescription for epipen, but they will be in a remote location (2-6 hrs from emergency medical services. Continue reading →

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Q: How do I approach my doctor to obtain a prescription for epinephrine?

Posted on January 18, 2011 by David Johnson, MD

Be direct and honest. Outline your training and your intentions. If your doctor has any questions direct her/him to the resources section our website for the Wilderness Medicine Field Protocols. Continue reading →

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Q: Is Xylocaina EV – HCl Lidocaine and epinephrine a sufficient replacement of epinephrine ampules in a case of anaphylaxis?

Posted on January 11, 2011 by David Johnson, MD

Q:  I went to the pharmacy looking for ampules of epinephrine, but they do not sell it. Instead, they sold me Xylocaina EV – HCl Lidocaine and epinephrine.. Each ml has Lidocaine HCl monohydrate equal to 20mg of HCl of … Continue reading →

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Q: What do you think about using prednisone in place of benadryl after epinephrine administration to treat anaphylaxis?

Posted on January 4, 2011 by David Johnson, MD

Prednisone is an important adjunct in the management of anaphylaxis, especially where an evacuation is many hours away. For a dose or 2 in a person not allergic to them (yes, people can be allergic to prednisone), prednisone offers an excellent insurance policy. For most programs I would consider it to be optional. Continue reading →

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Q: In anaphylaxis, why does the bronchial constrict and capillaries dilate?

Posted on December 16, 2010 by David Johnson, MD

Q: It seems counter intuitive that in anaphylaxis, the systemic capillaries dilate and the bronchial constrict. Histamine signals dilation (relaxation of the smooth muscles) of blood vessels, and increased permeability of capillaries, causing edema / inflammation. The bronchial tree also … Continue reading →

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Q: If there is no epinephrine available, could an albuterol inhaler be used until benedryl takes effect in anaphylaxis with respiratory distress?

Posted on October 4, 2010 by David Johnson, MD

Q: With respiratory distress in anaphylaxis, if no epinephrine is available could an albuterol inhaler be used until the benedryl takes effect? It isn’t mentioned in the study materials or in the recent WAFA course I attended. Seems to me that inhalers are a lot more common than epi pens. Continue reading →

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Q: Is there a connection between shellfish allergies and iodine?

Posted on August 4, 2010 by David Johnson, MD

The allergen in shellfish is a protein, not iodine. Some people with iodine allergies really have a topical sensitivity to iodine (e.g., povidone iodine; Betadine), usually a much different kind of reaction than the immediate reaction found with anaphylaxis. Continue reading →

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Q: Can ingestion of a steroid cream be equivalent to ingested prednisone for acute asthma or anaphylaxis?

Posted on January 6, 2010 by David Johnson, MD

If there was nothing else available, would ingestion of a steroid cream be a suitable and effective alternative for prednisone?
Continue reading →

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