Protocol-anaphylaxis

[chas*e]

I am wondering what protocols do the members have for post-envenomation(after the normal envenomation medical protocal prior to the hospital drive) and if you are envenomated, do you watch for signs of anaphylaxis and treat yourself if necessary? On many occassions the signs of early envenomation mirror anaphylaxis(coughing,itching,discharge..ect..)Epin ephrine (a.k.a. adrenaline), and antihistamines such as Benadryl, reverse the symptoms of anaphylaxis, and work best if given early, just after the tag. An Epi-Pen however is only a temporary fix. In my researched experience, symptoms may return full force within 20 minutes of an epinephrine injection.
One question I have is that Benadryl is a low dose antihistamine while there are others such as Cromolyn(nasal spray) that have a greater antihistimine in solution....also immediatly upon envenomation from low-venom-reaction species(copperheads and some Sistarus-pygmy rattlesnakes) should an antihistamine be self administered before 911 emerg treatment(Epi-Pen ect)???....I have never(touch wood) been tagged by any Hot....but having a envenomation protocol has always been a good idea.

[Mustangrde1]

Chase

Yes I do have a protocal in the event of a bite. 1st thing is to secure the snake and put it away. 2nd is to write down exact species. 3rd is contact a friend with antivenom and to inform him what hospital im on route to. 4th is to gather all the information on the species, I do keep a book with all the current information on all species of venomus I keep including my own records of feeding and medication they may be on. this book also has my DNR in it and in the event im not able to make disissions for myself who has power to do so. 5th is to make the most dreaded phone call to my wife.

[chas*e]

I also have the same protocol and same problem with my wife..lol....but the question is.. whether to use an antihistimine after the tag to reverse any anaphylexic shock symptoms....I just heard this protocol and was wondering if there is anything to it..or as I used to think before...no medications at all until a hospital.

[eyespy]

I have an anaphylaxis protocol, but it's not for snakebite as I don't keep hots. I have an anaphylactic reaction to latex and have gone into cardiorespiratory arrest 15 times. It's best to have your family doctor go over your medical history and tailor a protocol to you personally.

For me, it's critical to get epinephrine, antihistamines and steroids on board as soon as possible as I can code in under 2 minutes so I have to take my meds before calling for help. My personal protocol is Epi-pen, 75-100 mg of Benadryl injected into a muscle, and 40-60 mg of injected steroids such as Solu-Medrol. Protocol doses are based on the amount of immune system nasties such as IgE and tryptase that normally circulate in your system and so must be personalized by your doctor by averaging bloodwork taken both when you are having an allergic reaction to something and when you are stable. So if you've never had a severe allergic reaction to anything you might not have a pre-medication protocol and it might be best for you to wait until help arrives.

Cromolyn will not help with anaphylaxis, it's an anti-inflammatory/mast cell stabilizer rather than a true antihistamine. It can keep the mucus membranes from going into spasm that can close your airway, but will not prevent gastrointestinal or cardiac symptoms.

[chas*e]

Ya...welll thats good to know... go figure the pharmasist said that Cromolyn was the strongest antihistamine without a prescription...in canada you need a prescription for Epi-Pen and Benadryl...it is hard to find a doctor to script you for snake bite...

[eyespy]

Really, they won't script you for preventive medicine? In the US any doc that refused to do that risks losing his license. We can get Benadryl liquid and pills over the counter, but injectables need prescriptions.

[reverendsterlin]

part of medical envenomation teams job is to monitor patients physical symtoms to get their game right. I figure anaphylaxis would be caused more from allergy to the serum than to the venom.

[chas*e]

You are most likely right ...I would have thought so myself but I was reading an article that states that some self administration of an antihisamine is a good move prior to the 911 responce arrival...I was wondering what others thought about this

[eyespy]

Well, it's kind of a numbers game as to whether the venom or the antivenin is more likely to cause a reaction. Which have you had more exposure to, horses or snakes? Here in the Philadelphia area more people have anaphylactic reactions to the venom itself than antivenin because so many folks in this urban sprawl have never had close contact with horses. Fortunately, both types of anaphylaxis are very rare but every time you come into contact with proteins it slightly increases the risk your body will form antibodies and you will have a reaction.

[chas*e]

Correct....6 or a half dozen

[reverendsterlin]

never been exposed to venom but have ridden horses all my life

[chas*e]

LOL good point

[eyespy]

Remember that you don't have to be tagged to be exposed to venom proteins. Merely handling your hots gives you some limited exposure and that's enough to trigger antibody production in some folks. So even a first bite can potentially cause an allergic reaction, although it's a remote possibility.

[chas*e]

Yes that is correct...as you know, you can smell the venom when you clean the enclosures so, this allergic reaction is possible ...therefore; it might be a good protocol to self administer an antihistamine or Epi-pen upon envenomation....yes/no

[reverendsterlin]

maybe someone near a envenomation medical unit could call an ask for their opinion

[eyespy]

I don't know if they would give an opinion without knowing the particular person's medical history, list of current medications, and whatnot. Even the type of hot being kept makes a difference as antihistamines cause an increased heart rate which could potentially boost the actions of some hemotoxins.