Training for Anaphylaxis: A Kind of Vicarious Courage

By Dr. Paul Ehrlich

One of America’s military heroes (okay, it was General Patton) said that the way to deal with fear was training, which produces a “kind of vicarious courage.” I’m not given to military examples, even though I spent four years in the Navy, and did my training in allergy and immunology at Walter Reed Hospital. The real issue, however, is fear and conquering fear in an emergency. Make no mistake: the prospect of anaphylaxis is scary. As parents of a severely food-allergic or asthmatic child contemplate a really bad attack, they have to prepare, in the words of Rudyard Kipling, to keep their heads as all about them are losing theirs.

I was reminded of this yet again as we coached a mother through a practice injection of a spent EpiPen into a grapefruit at our support group the other night. First we presented some signs of anaphylaxis and asked her to think about the symptoms in sequence and when to distinguish between a Benadryl moment and an EpiPen moment. It was quite emotional, and so it should be. But she did it, and then we asked her to rehearse making a 911 call—a trip to the ER is a must after Epi. I urge all parents in this position to go through a similar process, and view a demo here.

By coincidence, we also had queued up a terrific guest editorial by blogger Janeen Zumerling that not only expresses a mother’s anxiety about 911 but provides an expert, detailed checklist for preparing. You can read it here.

A few additional points based on my many years of practice:

1) When you are prescribed an Epi-Pen you should, as Janeen recommends, also get an Anaphylaxis Action Plan or Food Allergy Action Plan (click on Action Plan on navigator bar above, or go directly to www.foodallergy.org.
2) When it has been given, go to the hospital—no exceptions. If you go without an ambulance, walk in and say, loudly, “anaphylaxis” to the admitting staff. That should obviate any intake delays.
3) When prescribed an Epi-Pen, check the expiration date before walking away from the pharmacist. If it has a date less than 12 months in the future, it should be rejected. I prefer 18 months.

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