| Anaphylaxis talk-night 26/9/2003 Transcript
- nearly 400 messages! |
Special guest Susie Q - Susan Gierthy.
Susan Leads the St Andrew Anaphylaxis Awareness Campaign.
|
| spud |
i suppose the first signs that appear
are skin swelling ect Anaphylaxis talk |
| spud |
flushig of the skin,nauseea,cramps |
| spud |
constriction of bronchial muscles |
| debs |
Hi susie. Susie is our invited guest for the evening
|
| debs |
Spud why do you say skin swelling first Spud? |
| spud |
i suppose it depends on the allergy really |
| debs |
Trying to prompt everyone into room 1 |
| Admin |
will have a look in a few mins |
| susie Q |
susie q says hello everybody |
| susie Q |
I am the Anaphylaxis Awareness Project Leader does
anyone have any questions |
| scrottocks |
what decides whwther to phone for an ambulance or
not |
| caroline |
What is anyones view on secondary reaction of anaphylaxis
12 hours after the initial reaction. |
| susie Q |
whenever there are breathing problems floppiness increased
heart rate |
| Admin |
is it hereditary? |
| White-Mini_Man |
sorry to start asking newbie questions - caroline
could you please explain the technical vocab u used |
| jdk6669 |
susie can u give some contact detail to project please
|
| debs |
Susie, I hear lots of people talking about allergies
and they connect Anaphylaxia to the discussion. When do you think an allergy
stops and Anaphylaxia starts? |
| susie Q |
secondary reaction can happen it can also happen immediately
neither are unusual |
| debs |
Well susie you asked for Q's how's that for a starter
|
| Admin |
jdk - will get susie to post in forum |
| caroline |
White mini man - what technical vocab |
| susie Q |
it can be hereditary or it can happen with no family
history |
| debs |
Scotty where where you on Mon |
| jdk6669 |
cheers admin |
| Admin |
can a simple allergy develop into anaph...? |
| susie Q |
allergies stop when the condition becomes serious
|
| Eric@54 |
Inherited and / or aquired? |
| susie Q |
mild allergies usually stay mild but if your body
becomes sensitive to that allergen it can result in anaphylaxis |
| White-Mini_Man |
, hypotension, also a flushed face. Not everyone gets
swelling and some people stop breathing instantly after contact. What you
also have to consider is, is it anaphylatic or anaphylatoid or local anaphylaxis
|
| White-Mini_Man |
oops - sorry |
| scottydog |
evening all, sorry I am A bit late |
| Admin |
and relationship to ones age? |
| caroline |
SQ - the secondary reaction I am talking about is
post treatment of adrenaline reaction which can occur often approx 9-12
hours after the initial anaphylaxis resulting in more servere symptoms.
Is this something you have come across |
| susie Q |
not something I have come across but was aware of
it |
| scottydog |
how common is this condition in First Aid terms? |
| debs |
Caroline what do you mean re the Adrenaline |
| Pilotmedic |
Sorry, I think I may have been in the wrong room earlier,
interested to know if reearch that suggests rise in allergy related problems
may be due to us becoming too clean? |
| susie Q |
anaphylaxis is very common in any term and becoming
more so every year so more FA will encounter it |
| caroline |
debs - adrenaline as in the treatment for anaphylaxis
|
| susie Q |
yes there is a lot of research into the cleanliness/pollution
etc but still not clear on the cause |
| Pilotmedic |
Shouldn't we be saying epinephrine these days;-) |
| debs |
Yes but did you mean whenever adrenaline is administered
the cas may have this problem |
| Eric@54 |
Epinephrine? |
| jdk6669 |
susie where do FA stand giving the epi pens |
| debs |
For example HA or overdose of Heroin |
| spud |
additives in food seem to be a problem like hidden
nuts ect |
| susie Q |
epinephrine is world wide name as the man made substance
|
| Admin |
anaphylaxis why have they started using the term -
I though it is justa severe ellergic reaction |
| Pilotmedic |
Yes we changed the name of adrenaline to the American
name - epinephrine a few years ago! Sorry only being flippant! |
| susie Q |
FA rules are if you have knowledge you can assist
if you are trianed you can do |
| scottydog |
food allergies appear to be on the rise, is it really
the big increase everyone thinks? |
| caroline |
Debs - no. research has shown that people can have
a secondary reaction after the initial reaction which can occur upto 12
hour later and be more severe than the first reaction. |
| Eric@54 |
Synthetic Adrenaline? |
| susie Q |
didn't say synthetic said man made |
| scottydog |
why is secondary reaction more severe? |
| debs |
Caroline is that as the full effect of the adren wears
off? |
| jdk6669 |
susie where do FA stand giving the epi pensvin the
pen |
| susie Q |
secondary reaction more severe due to levels of histamine
already built up within the body |
| scottydog |
thank you Susie |
| Admin |
I thought that the term was only introduced in the
last VAS manual? |
| scottydog |
am I correct in saying St AAA offer anapen training
courses? are they available in England from St JAA? |
| caroline |
Debs - adrenaline wears off after 1 - 2 mins of admin
and the body takes over producing hydrocortisone. So the reaction is a long
time after the initial treatment has worn off. |
| susie Q |
St AAA have led the way with training for all FA and
parents in the handling of this condition ST J as yet have not come on board
|
| debs |
So why then Caroline |
| scottydog |
Is there a reason for them not doing so? |
| Admin |
Is there an 'approved' syllabus of an epi course?
|
| Pilotmedic |
The VAS were a bit late talking about anaphylaxis,
probably because it was always considered such a rare condition until recent
years, wouldn't you say Susie? |
| caroline |
Debs - Im sorry not sure what you mean by why then
what? |
| susie Q |
yes totally agree but has always been mixed up with
asthma and breathing problems but glad to say it is more recognised now
|
| debs |
Why do we still use both epi and ana which one are
we changing to |
| Admin |
I also think that the term training... can be just
a tuerm to cover one's back side |
| susie Q |
St AAA have a syllabus for an approved course |
| scottydog |
What does it involve, time frame and costs? |
| susie Q |
both pens are still being prescribed with the Ana
pen becoming more popular and cheaper |
| Pilotmedic |
Would SAAA object to it the syllabus being posted
into the forum Susie? |
| caroline |
SQ who has approved the St AAA course. |
| Admin |
who 'approves'the course? |
| susie Q |
contact Susan at St AAA HQ |
| debs |
Adren wears off body is producing hydrocortisone so
why the after effect if no further stimuli has been given , Caroline? |
| Eric@54 |
Good for parents wth Kids with A? |
| Eric@54 |
The course? |
| jdk6669 |
susie wots the details |
| susie Q |
Anaphylaxis campaign, immunology doctor, St AAA Medical
Council and St AAA Insurers |
| caroline |
SQ - Im not sure that answers the question and you
give an indicator of who approves their course. |
| Pilotmedic |
Would SAAA object to it the syllabus being posted
into the forum Susie? |
| susie Q |
that would need to be checked over by our Taining
Manager |
| caroline |
SQ - The anaphylaxis campaign tell me that they do
not approve any courses |
| susie Q |
yes Eric this course is very good for parents and
gives them confidence in dealing with their children |
| debs |
More than one way to get apprval Caroline |
| debs |
Susie do you come south of the border to teach |
| Eric@54 |
Maybe They'll aprove then1 |
| susie Q |
David Reading from Anaphylaxis campaign has approved
this course his name is on the front cover of our training booklet |
| Pilotmedic |
I believe that in an anaphylactic reaction, the odaema
is due to an osmotic effect - or does it affect the vasoconstrictors hence
the vasodilation? - my one case had quite pronounced watery bumps and fingers
quite swollen. |
| susie Q |
Not yet Debs but watch this space |
| caroline |
Debs - its because the allergen interacts with bound
1gE which releases inflamatory mediators giving clinical signs that have
not been irradicated with initial treatment. |
| spud |
so,guys lets get back to basics,should we be looking
at the agents commonly responsible for anaphalaxis |
| Admin |
Should an epi pen be part of a first aid kit for schools?
|
| caroline |
The anaphylaxis campaign have told me that they do
not approve courses even when I gave them David name |
| susie Q |
we should be aware of the allergens that cause anaphylaxis
spud |
| susie Q |
no this is a prescription drug which is kept in the
school for that child which the teacher is trained to use |
| Pilotmedic |
Thanks - don't know what I did to produce those multiple
lines back thee! |
| scottydog |
does this come into controlled drug status? |
| spud |
thanks susie,shellfish,any more anybody? |
| susie Q |
it is termed a prescribed drug |
| Eric@54 |
P.O. |
| scottydog |
certain prescribed drugs are classed as " controlled"
is this the case? |
| spud |
milk and milk products |
| Xander |
How about eggs spud |
| susie Q |
lates, tropical fruits, oats, legumes, nuts |
| Pilotmedic |
...and bee stings - seems more common too? |
| spud |
nice one xander,vaccines |
| Xander |
Latex - there goes the gloves |
| susie Q |
yes Xander especially eggs of E322 as it is sometimes
known |
| susie Q |
nitrile gloves available in the beautiful shades of
purple, blue or aqua as seen in all Casualty shows |
| spud |
penicillin |
| Pilotmedic |
Yes my one case was a penecilin reaction spud |
| Xander |
Fruit, especially citric |
| susie Q |
spud I suffer from penicillin allergy and have had
two reactions to this drug |
| debs |
Morphine based drugs |
| Xander |
Fruit, especially citric |
| susie Q |
yes Zander remember the bananas |
| Eric@54 |
Nurse sued about latex gloves and won. hence widely
available now. |
| Xander |
How about pineapple? |
| scottydog |
Latex gloves now risk assessed by care homes much
more now! |
| debs |
Susie were they allergic reactions or cases of anaphylaxia?
|
| Eric@54 |
Indeed ! |
| spud |
did you go tachacardic susie? |
| susie Q |
maybe during our FA courses we should remember to
alert students to this possible danger of latex gloves |
| susie Q |
2 x anaphylactic reactions |
| Eric@54 |
Esp. before bandaging session! |
| susie Q |
yes spud had to stay 6 hours in hospital |
| Pilotmedic |
I suppose the important thing is to ensure first aiders
are aware of the earliest warning signs and so know how urgently they need
an ambulance, apart from shock treatment there isn't much else they can
do is there? |
| spud |
holy moses! |
| scottydog |
totally agree Eric@54 |
| Eric@54 |
I'm allergic to figs. |
| susie Q |
don't put them on in the first place |
| scottydog |
what would a f/aider do if no anapen to hand? |
| susie Q |
eric how do you react to the figs |
| susie Q |
urgent 999 basic life saving treatment |
| debs |
I remember having a very bad reaction to Sulphradine
max which I took once for stomach pain. Remember feeling very sweaty, short
of breath , lips were blue felt faint etc. Was trying to see if I had blotchy
skin (hypochondria) but my vision was too bleary. |
| Zac |
in the case of adrenaline there is an exemption that
allows a suitably trained lay person to administer for the purpose of saving
life |
| Eric@54 |
Turn red and breathing wheezy (symptoms ) Hate them
! (personal) |
| susie Q |
Zac all parents and people diagnosed with the condition
are given instruction as to using the pen |
| Eric@54 |
Carers Too |
| susie Q |
yes that includes anyone caring for a child |
| scottydog |
Carers only get training if a risk presents |
| debs |
Zac explain please |
| susie Q |
carers get training if the person has been diagnosed
and carries a prescribed injector pen |
| debs |
If I have training on how to use a pen does that mean
I can administer to everyone suffering from this as long as it is there
own medication? |
| susie Q |
as before if you have knowledge you can assist if
you have training you can do |
| Zac |
HSE states medcines legislation restricts the administration
of injectable medicines. adrenaline has an exemption as stated |
| Admin |
what % of the population may be at risk? |
| susie Q |
information was given out recently that 1 in 4 children
under 4 are being diagnosed with severe allergic reactions |
| debs |
Blimey that is high |
| Eric@54 |
Yes dothey grow out of it? |
| Pilotmedic |
My brother had an anaphylactic reaction after a bee
sting, although he had previously been stung by a bee without effect - is
this common? |
| susie Q |
not when it is a food allergy |
| Admin |
wow! thats a lot. How do the diagnose? |
| scottydog |
why should it be so high? |
| debs |
Susie do you personally link into the anaphylactic
campaign or does all you info come direct from SAA |
| susie Q |
can be produced from 3rd time contact 1st time there
is a reaction but may not associate symptoms |
| sheila |
pilotmedic that reaction is normal, reacton do get
worse as they have more |
| caroline |
Pilotmedic - he had a anphylaxtic rather than anaphylactoid
reaction and the next reaction could go either way. |
| Eric@54 |
did the bee get him near the mouth Pilot medic? |
| susie Q |
debs, some info comes from anaphylaxis campaign, some
comes from doctors and personal experience |
| Pilotmedic |
No Eric it was to his arm |
| debs |
I know you have had a lot of personal experience how
is fraser at the moment |
| susie Q |
just left my house, quite interested to hear about
tonits topic and he is fine thanks |
| Eric@54 |
Good! |
| debs |
He must be pleased to have so many people interested
in the welfare of him and his fellow sufferers |
| sheila |
i have found that some parents do not fully understand
the implications of the epipen |
| susie Q |
some parents are not given a great deal of instruction
on the use of the pen. time and cost restrictions and nhs are responsible
|
| sheila |
i agree, and also some are nervous of asking Q's |
| Admin |
is it improtant to identify the substance / |
| caroline |
how are the nhs responsible |
| susie Q |
debs fraser is very interested and hopes people will
take on the course to keep other children safe as well |
| Admin |
substance that caused the reaction? |
| susie Q |
caroline, misspell it should have read at nhs |
| Eric@54 |
Well put! |
| Pilotmedic |
Most interesting, surprised at the 1:4 children affected
as mentioned earlier - I have a 3 year old - so far so good but I will keep
a close eye on him! Meanwhile I'll let him eat dirt to build up his immune
system! |
| caroline |
SQ - sorry not sure what you mean |
| scottydog |
If this is such an issue, why do NHS not do more to
educate others? |
| Eric@54 |
Way to go Pilot ! |
| susie Q |
substance identity is important at hospital diagnosis,
FA diagnosis needs to recognise the urgency of the situation |
| scottydog |
what has eating dirt got to do with this? |
| SilentShadow |
she means "restrictions at nhs" instead
of and nhs |
| sheila |
when i teach in schools there are school nurses that
go in and do about an hour talk on pens also the parents are usually invited
|
| susie Q |
cut backs throughout the whole nation restrict the
amount of help being given to any conditions |
| scottydog |
i guess that makes sense! |
| debs |
my dad used to say you have to eat some dirt before
you die, could we now be saying if you don't eat some dirt you may die |
| spud |
got a point there pilotmedic,world is becoming a more
sterile place! |
| Pilotmedic |
Sorry scotty - being flippant again - but was referring
to the research into whether overcleanliness may be a causative factor |
| susie Q |
sheila if that is school procedure that is fine as
long as awareness has been addressed |
| caroline |
make sure that the cats not crapped in it !!!! |
| scottydog |
Oh, is this a local thing?never heard of this in Glasgow,
where we eat dirt for fun! |
| susie Q |
thanks silent shadow |
| Eric@54 |
Or Nescessity! |
| SilentShadow |
ok |
| Pilotmedic |
He loves eating the cats food! Not that he doesn't
have other normal options mind you! |
| sheila |
awareness is my department as well as talking about
pens S&S etc |
| susie Q |
well doen sheila keep up the good work |
| Admin |
I guess the odd earth worm helped as a kid :-0 |
| sheila |
i have a thing about anaphylaxis and i believe if
the f/a instructor does not make a big thing oit where do the lay people
learn |
| Eric@54 |
treat the Symptoms. |
| scottydog |
would many f/a instructors have great deal of knowledge?
|
| Pilotmedic |
So that's what you were brought up on then Dave?!
|
| sheila |
never took a liking to worms admin!! |
| susie Q |
up to the trainer to get the information |
| Pilotmedic |
Good point Scotty |
| sheila |
perhaps it is the nurse in me or because i have experience
from waterloo station when worked there |
| Eric@54 |
so you've tried one then Sheila? |
| scottydog |
where can one obtain suitable literature on this subject,
that is written basic english? |
| SilentShadow |
yes i am debs |
| sheila |
many moons ago |
| scottydog |
where can they get credible information? |
| sheila |
i will look up the address-hold on |
| scottydog |
Red Cross do not have it, as I understand it |
| susie Q |
from St AAA HQ or your local exec who will be only
too happy to come out and do a course for your scottydog |
| Eric@54 |
What credible info? |
| scottydog |
whilst a scottydog, I am in Birmingham now....can
I cantact you for details? |
| susie Q |
yes please do |
| Admin |
SusieQ - maybe you could write a few word for the
Forum or a fewmore words for an atricle for the site? |
| sheila |
anaphylaxis campaign, po box 275, farnborough, hampshire,
GU14 6SX there are others |
| scottydog |
Eric@54, some stuff people read may be a level above
them...plain English is good for this wee puppy! |
| caroline |
SQ - I understand that some Drs administer sublingual
antihistamine what are you views. |
| Eric@54 |
sorry |
| Pilotmedic |
Sadly, I am getting called from down below - think
my time is up! Thanks for the chat everyone and Debs, Susie and Sheila well
done ihas anyone saved a transcript? It would be great to read in the forum
later? |
| susie Q |
admin i will check with training manager and get back
to you about the forum |
| sheila |
bye pm |
| Admin |
Every thing typed in the forum is stored in a database
- i will put it up on the site |
| susie Q |
sorry don't have a view on what doctors do I am a
FA and that is what concerns me |
| Pilotmedic |
Sorry just realised - when I said from down below
I meant my wife downstairs! |
| scottydog |
bye PM |
| debs |
BYe pilotmedic chat later |
| scottydog |
yeh, PM any excuse! |
| Admin |
SQ can you say give 3 or so points to consider as
a FA? |
| susie Q |
admin can you clarify question |
| Eric@54 |
Bye |
| Admin |
If a FA comes accoss a person who may be having a
reaction, what steps should you take, lookout for or carry out? |
| caroline |
SQ - not sure your answer is fare, is this not a discussion
on anaphylaxis |
| susie Q |
easy breathe/vomit position, urgent 999, monitor and
check for medication |
| susie Q |
yes but not doctors procedures |
| Admin |
so 999 first before medication |
| sheila |
dr's do their own thing-do they not?SQ |
| susie Q |
no medication if available first |
| scottydog |
susie-would cas have identity card as Diabetics have?
|
| caroline |
Admin - lay them down, feet up, DRABC, if breathing
difficulties and adrenaline available, administer into thigh and observe
as in FA. Dont forget 999 |
| susie Q |
some do, SOS, medi alert I have one so does Fraser
|
| sheila |
i agree 999 is vital F/A do not administer pens without
training, but they can help the person look for it |
| Eric@54 |
Medic alert ? |
| debs |
Caroline susie was asked to chat to us regarding the
First Aid of Anaphylaxia which I think she is doing a wonderful job of.
Let's not push her into a corner for any answeres |
| susie Q |
casualty should never be laid down as breathing problems
dictate to you in the FAM |
| scottydog |
I know SOS/MEDIALERT, is there a card from Any. Campaign
that you are aware of? |
| SilentShadow |
FAM? |
| susie Q |
silent shadow First Aid Manual |
| caroline |
SQ Sorry in anaphylaxis you lay the Cas down as per
shock |
| SilentShadow |
ok thanks SO |
| scottydog |
sorry, susie has been very patient and really great
informative evening! |
| susie Q |
scottydog people can make up cards of their own and
carry them. they should have some indication of serious conditions |
| Eric@54 |
First reassure the cas. |
| debs |
Caroline surely we would not put someone with breathing
difficulties on their back with feet up? |
| SilentShadow |
SQ sorry |
| sheila |
no caroline-breathing difficulties mean lean them
against something |
| Admin |
is there a common type of reaction - i.e. localised?
|
| scottydog |
Thanks, just wondered if there was a " designed
care" as diabetes/epilepsy....thanks |
| caroline |
Debs - before administering adren you do as it lower
the blood pressure initial before rasing it. |
| Eric@54 |
Good Greif ! this is too fast for me! |
| susie Q |
you can have a localised mild reaction |
| Admin |
SQ - when you want to call it a night, please let
us know |
| debs |
Admin Breathing Difficulties are one of our main concerns
which is why I'm a little worried that Caroline wants to lay them down |
| debs |
I can not administer adrenaline. Basic FA |
| caroline |
Debs check out Henderson 1998 in emergency nurse |
| susie Q |
as first aiders we must follow FAM which states breathing
problems must be sat up |
| sheila |
why henderson 1998. Caroline? |
| debs |
Not worried about Henderson 1998 (nothing newer) I
have the 8th edittion of the VAS which is my bible |
| Eric@54 |
Duty of Care Debs? implied consent? |
| scottydog |
I should sit cas in position that encourages easier
breathing....lying down will not assist that aim! |
| debs |
Not worried about Henderson 1998 (nothing newer) I
have the 8th edittion of the VAS which is my bible |
| caroline |
SQ - research shows that cas can stop breathing very
quickly |
| Eric@54 |
LOL |
| scottydog |
refer to page 123 8th edition manual |
| sheila |
duty of care is ok if one knows what one is doing:
|
| Zac |
SQ congratulations for allyour effort and keeping
to First Aid ! |
| scottydog |
why hendersons? |
| susie Q |
glad to see you are all in agreement about the seated
position as having an apaphylactic reaction there is no way i wanted to
be laid down |
| Admin |
OK Let's have our last questions, and thank SQ for
a great and interesting evening |
| scottydog |
yes thanks susie, learned a great deal tonight......and
i will contact you for more info |
| debs |
Susie your message is loud and clear and almost agreed
upon! |
| Eric@54 |
Because you can't breathe . |
| sheila |
SQ we have not met before, i assume you do have allergies-if
i may ask |
| susie Q |
zac glad to see you are still hear |
| debs |
Silent but deadly hey Zac |
| Eric@54 |
he might be from Glasgow1 |
| Zac |
SQ with you all the way ! |
| susie Q |
sheila yes penicillen allergies grandson multiple
anaphylactic and thanks Zac he most definitely is one of us |
| nurse-2 |
it's been really interesting, thanks Susie Q |
| spud |
thanks sq a very interesting and informative discussion
|
| Admin |
Let me have web site info (email me / or forum) and
I will put a link to your site. |
| SilentShadow |
have you ever had an Anephylactic shock? |
| scottydog |
great idea Admin |
| susie Q |
silent shadow yes I have had two |
| caroline |
SQ - yes if they are having an anaphylaxtic reaction
but you should lay them before administering the pen due to the |
| sheila |
i have seen people with the anaphylatic |
| SilentShadow |
wow 2 |
| sheila |
reaction and have dealt with it, best wshes SQ |
| Admin |
BIG thanks SQ - Hope the wine is helping out |
| Eric@54 |
Bye!Susie! |
| susie Q |
thanks to everyone who took part tonight, loved every
minute of it, hope you all enjoyed it and my last word is be aware, be anaphylaxis
aware |
| scottydog |
respect is due to Susie, and all who arranged this
evening! |
| Eric@54 |
CU |
| debs |
What's all this about wine and chocs |
| SilentShadow |
thanks SQ |
| susie Q |
can't be sent down the telephone line sorry debs |
| nurse-2 |
think we missed ut somewhere Debs! |
| debs |
Bye Susie thanks and very well done Heres hoping this
will trigger many more chat nights |
| SilentShadow |
yup |
| Admin |
SQ - like it or not - I've made you a gold member
as a small token of our appricaition |
| scottydog |
I hope so, this was my first one and it was great
|
| susie Q |
bye and thanks |
| scottydog |
take care |
| Admin |
bye and BIG thanks again SQ |
| scottydog |
Oh, goody.....proposed dates in mind? |
| SilentShadow |
hope 2 tlk soon |
| SilentShadow |
talk** |
| susie Q |
may I say a big to my typest Brenda who supports me
every time |
| susie Q |
you can see my spelling is rubbish |
| debs |
Well done brenda, now I realise why the wine and chocs
you two are having a party again!! |
| SilentShadow |
thanks brenda |
| Admin |
yes Thanks brenda |
| susie Q |
hope the conference goes well |
| scottydog |
Thanks Brenda |
| spud |
cheers brenda! |
