Allergies and Hayfever

As suffers know, hayfever (or seasonal allergic rhinitis as it is known medically) goes hand in hand with the sun - and summer is a very miserable time of year for some. As I write this I am sneezing and my nose is running,so I know this is the right time to send this first newsletter. However for some the effects of hayfever have been with them for a while. Others still have the pleasure to come, all depends on the type of pollen they are allergic to. Tree and grass pollenare most common.

If you want to find out a little more about allergies read on.

Allergies including hayfever

An allergy is an abnormal reaction of the body’s immune (defence) system to a normally harmless trigger (or allergen). Common triggers for mild reactions include pollen, dust, wasp and bee stings.

There are lots of things that come under the umbrella term of allergy and an allergy can present in a variety of different ways including physical and emotional signs. It is how we recognise these signs and deal with them that is important.

Risk Assessments

During the summer we are more likely to be running activities outdoors but are we really prepared. Does your risk assessment cover the potential for allergic reactions?

Have you considered if any of the group have specific allergies? / 1 in 4 people have an allergy
50% of children have at least one allergy
Has the grass recently been cut close to where the activity is taking place? / pollen can be carried in the air and propelled by the wind so even in areas without grass people can get hayfever
Do those with asthma / allergies have their medication and where appropriate have they taken their medication / asthma is an allergic reaction
antihistamine takes 30 minute to take effect
auto injectors are life savers
Have you considered directions for the emergency services and access routes / Fields don’t generally have a post code and access may be away from the headquarters.

Physical Reactions

  1. Skin

/ An itchy rash is often the sign of an allergic reaction. The rash might be present in severe anaphylactic reactions too - so if there are any other features of severe allergy, suspect anaphylaxis.
This rash is urticaria, nettle rash, welts, wheals or hives. The marks are often different shapes and sizes, surrounded by a red flare. They are very itchy.
  1. Eyes

/ Watery, itchy eyes are a sign of allergic type reactions. The redness often covers the entire eye. Allergic conjunctivitis is not painful. Irrigating the eyes can help with symptoms. A pharmacist may able to recommend some soothing eye drops. If the eye is painful, eye movements are sore, the tissue around the eye is red or swollen or the patient is unwell in any other way make sure they seek advice from a healthcare professional.
  1. Observations

Level of Response (AVPU)
Respiratory rate
Pulse rate
Location and size of a rash
Changes in behaviour
Observations are really important. They can help to warn you that the patient is about to get worse. Even if help is on the way, observations help provide you with the evidence your clinical actions were appropriate. You might not call an ambulance immediately - if your initial observations were normal, this would be appropriate. / Is the patient alert or only responding to voice or pain, or are they unresponsive.
Are they breathing normally or is it difficult and/ or wheezing?
What is happening to their pulse?
Is there a rash (can you draw round it and note time to see if it changes),
Has their behaviour changed? Are they irritable? Sometimes children cannot verbalise a change so it is shown by mood changes.

Treatment

Minor Reactions / Assess the severity
Remove the trigger, if possible
Treat the symptoms
Allow patient to take own medication or give antihistamine if permitted
Severe Reactions (Anaphylaxis)
/ Follow patients own protocols, if known and available
Or
Dial 999 (say you suspect anaphylaxis)
Use the patients auto injector (epipen/Jext Pen)
Help the casualty to sit up in position which aids breathing or shock position if feeling faint
Reassure everyone
Monitor and record observations
Use spare auto injector after 5 minutes if not improvement or symptoms return.

Myth Buster

Myth One:
An anaphylactic reaction occurs instantly:BUSTED
Allergic reactions that occur instantly are normally
caused by injected drugs.
Most other reactions take a bit longer to become apparent.
Stings take ten to fifteen minutes to cause fatal anaphylaxis, and food takes on average 20 - 45 minutes.
Make sure you stay vigilant. /
Myth Two:
All allergic reactions are life threatening: BUSTED
Most allergic reactions are annoying and not life changing. Very few are life threatening
However we have to be prepared for the worst case scenario. /
  • An estimated 21 million adults in the UK suffer from at least one allergy(Mintel, 2010)
  • An estimated 10 million adults suffer from more than one allergy(Mintel, 2010)
  • 20% of the population are affected by allergic rhinitis(Allergy The Unmet Need, 2003)
  • There are under 800-900 deaths per year from allergic rhinitis.

Myth Three: An allergic reaction will only occur when in close proximity to the allergen BUSTED / Whilst physical contact with an allergen will cause a reaction in the skin, most allergies are caused by the allergen being in the air with some sufferers having a reaction whilst still a few meters away from the trigger. Outdoors this distance can be even further as the allergen is carried in the breeze.

Thank you for your time reading this newsletter. Please let me know what you think of it.

Comments (positive or negative) and suggestions for future newsletters can be sent to me at Keith Griffin, County First Aid Advisor, Durham Scout County