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During an allergic reaction, the immune system can react very severely. With a severe allergy, a potentially life-threatening reaction called anaphylaxis can occur. Anaphylaxis can cause shock, a drop in blood pressure, and trouble breathing. In some cases, death may occur.
Epinephrine, also known as adrenaline, is a drug that can slow down or stop an anaphylactic reaction.
An epinephrine auto-injector is a device that has a syringe and needle that can inject a single dose of epinephrine. Commercial brand names include EpiPen®, Auvi-Q® or Allerject®, and others.
If an employer opts to offer additional first aid measures (including over-the-counter medications, administration of oxygen, use of epinephrine auto-injectors, naloxone, etc.), it is suggested that they first seek legal counsel so that they are aware of any liability issues, and to check with your local jurisdiction responsible for health and safety. For example, in some jurisdictions, distribution of over-the-counter medications is not recommended (although an individual who can purchase using a vending machine may be permissible). In other jurisdictions, distribution of over-the-counter medications may be permitted under specific circumstances (including the appropriate training of first aid personnel).
Symptoms usually occur within minutes of exposure, but there can also be a delay of 30 minutes or more. There can be an equally serious second reaction one to eight hours after the initial reaction. A range of signs and symptoms may occur, including:
Triggers commonly include:
Some people may react to products in the workplace. Examples of workplace allergens include latex, bee stings, and certain chemicals (e.g., diisocyanates). In the situation where the allergic agent is known, workplaces can take steps to control exposure (e.g., elimination, substitution).
Or, for example, if a person who is allergic to insect stings is stung while working outdoors, there is need to have help from a co-worker and to have an epinephrine auto-injector close by. This situation could have other hazards that contribute to the severity of the situation such as working alone, or working at heights (e.g., the person reacts so severely that they cannot inject him/her self, or a person faints from a reaction and falls from a ladder).
Where organizations have decided to provide an epinephrine auto-injector:
During a reaction, it may not be possible for the person to inject the drug themselves. Make sure immediate co-workers know how to recognize signs of a reaction, where the auto-injector is located, and appropriate training on how to use it. Co-workers should know how to call for first aid personnel or for outside emergency responders.
In some cases where exposure to an allergen is possible, it may be necessary to assign that person to other duties. For example, if the person has a severe allergy to bee or wasp stings, consider assigning that individual to other duties, away from the area with a hive or nest (especially if the work involves disturbing the hive or nest). Or, if the workplace serves food (or has a social “pot luck” event), be sure to inform participants that there is a food allergy in advance, avoid cross contamination, and label all foods regarding their ingredients.
If the person indicates they are having a severe allergic reaction, or if you suspect a person is having a severe reaction, using an epinephrine auto-injector would be appropriate. No harm will be caused to a person by providing a single injection if it turns out they are not having an allergic reaction.
When using an injection method, be aware of the hazards and risks associated with needlestick injury and the transmission of infections.
In most cases, the person will feel the epinephrine working right away. They may also feel a rapid heartbeat and nervousness. Always call for first aid or medical assistance. Symptoms can return or get worse after giving the injection. It may be necessary to administer a second injection, especially if the person does not respond to the first dose within 5 minutes, and if medical emergency responders have not arrived to the location.