From the Guidelines
If you develop hives along with wheezing, you should go to the emergency room immediately, as this combination of symptoms suggests a potential anaphylactic reaction, which is a severe, potentially life-threatening allergic response 1.
Key Considerations
- Anaphylaxis requires prompt medical attention because it can rapidly progress to difficulty breathing, drop in blood pressure, and loss of consciousness.
- While waiting for emergency services or on your way to the ER, taking an antihistamine like diphenhydramine (Benadryl) 25-50mg if available is recommended, but do not delay seeking emergency care 1.
- If you have been prescribed an epinephrine auto-injector (EpiPen, Auvi-Q) for previous allergic reactions, use it according to your healthcare provider's instructions 1.
Education and Management
- Patient education on the signs and symptoms of anaphylaxis and the use of epinephrine as the only first-line medication for the treatment of anaphylaxis is crucial 1.
- After treatment, follow-up with an allergist to identify triggers and develop a management plan, which may include carrying emergency medication and wearing a medical alert bracelet.
- Antihistamines and glucocorticoids may be considered as second-line medications following epinephrine administration, but their role in preventing anaphylaxis is still uncertain and requires further study 1.
From the Research
Education on Hives and Wheezing
When presenting to the ER with symptoms of hives and wheezing, it is essential to understand the potential causes and severity of the condition.
- Hives and wheezing can be symptoms of an acute allergic reaction, which is a rapid-onset, IgE-mediated hypersensitivity reaction 2.
- These symptoms can range from mild to severe, with anaphylaxis and anaphylactic shock being the most severe, life-threatening forms of allergic reaction 2.
Importance of Urgent Medical Attention
- Anaphylaxis and anaphylactic shock require urgent airway monitoring and support due to their fast onset and potential for decompensation 2.
- Education on the management of allergic reactions and anaphylaxis is crucial for healthcare providers, including the use of epinephrine, corticosteroids, antihistamines, and other adjunctive therapies 2.
Grading of Symptoms
- Guidelines are available to help healthcare providers grade the severity of symptoms, which can aid in determining treatment and disposition 2.
- Understanding the causes of allergic reactions, including food, insect stings, medications, and other factors, can help healthcare providers provide appropriate education and treatment 2.