Allergies and Anaphylaxis

Some of the most common allergens include:

• Grass and tree pollen (hay fever)

• Dust mites

• Animal dander (tiny flakes of skin or hair)

• Food allergy (particularly fruits, seafood and nuts)

• Medicines (including antibiotics such as penicillin)

Symptoms of an allergy are often mild and can include:

• Sneezing

• Wheezing

• Itchy eyes

• Skin rashes

• Swelling

Anaphylaxis (or anaphylactic shock) is a severe allergic reaction.

The reaction can be very fast, happening within seconds or minutes of contact with the thing a person is allergic to.

When anaphylaxis occurs, a chemical called histamine is over-produced, causing one or more life-threatening Airway, Breathing or Circulation problems.

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Treatment for Allergies

• If possible, remove the allergen and flush the area of contact.

• Give the child allergy medication such as an antihistamine.

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Signs and Symptoms of Anaphylaxis

• Blotchy skin rash or flushing

• Swelling of the tongue and/or throat

• Difficulty in swallowing or speaking

• Vocal changes (hoarse voice)

• Wheeze or persistent cough or severe asthma

• Difficult or noisy breathing

• Stomach cramps or vomiting after an insect sting

• Dizziness / collapse / loss of consciousness

• Sense of impending doom

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Treatment of Anaphylaxis

• Remember to stay as calm as possible so that you can reassure the child:

• Lie the child down and administer an adrenaline injection(if the child carries one with them) immediately. (Assist the child to use their auto injector, if they are able to)

• Call 999 for an ambulance and say ANAPHYLAXIS (if you mentioning "anaphylaxis", a ambulance will be dispatched faster)

• Raise their legs if they feel dizzy or faint or appear pale and sweating

• Raise their shoulders if they feel wheezy or short of breath

• If the child becomes unconscious, check Airway and Breathing and start CPR if necessary

• If the child has more than one auto-injector, the dose of adrenaline can be repeated at 5 minute intervals if there is no improvement

• Important: DO NOT stand the child up once they are lying down

Learn how to use EPIPEN and JEXT (two common types of adrenaline injection)

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Insect Bites and Stings

Bites and Stings
An insect bites by making a hole in your skin to feed. Most insects sting as a defence, injecting venom into your skin. In the UK:

• Insects that bite include midges, mosquitoes, fleas and bedbugs

• Spiders, mites and ticks can also bite

• Insects that sting include bees, wasps and hornets

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Signs and Symptoms of an insect bite or sting
Insect bites and stings can cause the skin around it to become red, swollen and itchy

• This can be painful, but it’s harmless in most cases

• The affected area will usually remain painful and itchy for a few days

• The severity of bites and stings varies depending on the type of insect involved and the sensitivity of the child

• In rare cases, some people can have a serious allergic reaction (anaphylaxis) to a bite or sting that requires immediate medical treatment.

NOTE: If there’s a lot of swelling and blistering, or if there’s pus, it’s advisable to seek medical advice.

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Treating insect bites or stings
Most bites and stings can be treated by:

• Washing the affected area with soap and water

• Placing a cold compress (a flannel or cloth soaked in cold water) over the area to reduce swelling

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If a child has been stung by a bee or a wasp:

• Reassure the child

• If the sting is visible, carefully scrape it off the skin with the edge of a credit card or the flat edge of a knife

• DO NOT use tweezers as you may push the poison further into the skin

• Elevate the injured area, if possible

• Apply a cold compress / icepack (or a flannel or cloth cooled with cold water) for 10 minutes to reduce swelling

• If the sting is in the mouth give an ice cube to suck on or sips of cool water

• Try to stop the child from scratching the area as it can become infected

• Check for severe allergic reaction

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Check for severe allergic reaction
Dial 999 and ask for an ambulance if the child shows any of these symptoms after a bite or sting:

• Wheezing or difficulty breathing

• Nausea, vomiting or diarrhoea

• A fast heart rate

• Dizziness or feeling faint

• Difficulty in swallowing (dysphagia)

• Confusion, anxiety or agitation

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External Bleeding

Sit or lie

• Help the casualty to sit or lie down and reassure them

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Examine

• Examine the wound to look for embedded objects (do not remove an embedded object)

• Note how the wound is bleeding, so that you can describe it to medical staff when it is covered with a dressing

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Pressure

• Apply continuous direct pressure over the wound with your fingers or palm of your hand to stop the bleeding. If available, place a sterile wound dressing or non fluffy, clean cloth pad over the wound and apply pressure over it.

• Once the bleeding is under control, secure the dressing or pad with a bandage. It needs to be tight enough to maintain pressure but not so tight that it restricts blood flow to the rest of the limb.

• If the dressing gets saturated with blood, remove it and make sure you are applying direct pressure to the exact point of bleeding. Only redress the wound once bleeding is controlled.

 
Infection Control
Before giving first aid:

• Wear gloves and aprons that are not thin, worn, or torn

• Wear two pairs of gloves if possible

• Wear a face mask, if possible

• Do not cough or sneeze onto the casualty’s wounds

• Use sterile bandages and dressings

After giving first aid:

• If you are accidentally cut and there is blood from the casualty near or in your cut, wash immediately, cover the wound and seek medical advice

• Gloves, aprons and soiled dressings should be double bagged and securely sealed before disposal, ideally in an orange clinical waste bag

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Catastrophic Bleeding

If a casualty is losing blood so quickly that they are likely to die in minutes if nothing is done to stop it, you need to prioritise this above everything else.

Once the bleeding is under control you will be able to go back to your primary survey and check Airway, Breathing and Circulation (ABC).

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Treatment of Catastrophic Bleeding – Wound Packing

Haemostatic Dressings:

• If a wound is deep and bloody and bleeding cannot be stopped with direct pressure you need to pack it  - ideally with a haemostatic dressing.

• These dressings are  treated with an agent or chemical that assists with the formation of blood clots and will stop the bleeding more quickly.

• If you don't have a haemostsatic dressing, use any bandages, gauze or clean cloth available.

Note: Haemostatic dressings are not suitable for wounds to the  chest, airway, eyes or the head if brain tissue is exposed

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Wound Packing - Step by Step:
Suitable for deep wounds to the shoulders, armpit, buttocks and groin

DO NOT pack wounds to the neck, chest or abdomen

1. Move any clothing away to expose the wound

2. Place your gloved fingers — with or without a dressing — into the wound to apply initial pressure to the exact point of bleeding (the vein, artery or both). You may need to mop away excess blood to locate the source of the bleeding.

3. Keeping pressure on the bleed, use your other hand to tightly pack the wound with a haemostatic dressing, bandages or other clean cloth

4. Ensure the dressing or cloth reaches as deep into the cavity as possible and stuff to capacity

5. Apply very firm direct pressure with both hands directly on top of the bleeding wound for at least 10 minutes (approximately 3 minutes if you are using a haemoststaic dressing)

6. If bleeding is under control, secure the wound packing with another dressing

7. Maintain pressure until medical help arrives. Inform medical professionals about the materials you have used to pack the wound

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Use tourniquet:

A tourniquet is a band or strap that is wrapped very tightly above a wound to an arm or leg to apply pressure and stop severe bleeding. It should only be used for life-threatening bleeding that cannot be stopped by applying direct pressure.