Would benadryl help anaphylaxis any?

Remi

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Do the H2's really help at all? My understanding is they do not. I give them (along with H1's and steroids) pre-emptively at times, but when I do, it unfortunately it has as much to do with legal indications as clinical ones.
 

wilderness911

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Do the H2's really help at all? My understanding is they do not. I give them (along with H1's and steroids) pre-emptively at times, but when I do, it unfortunately it has as much to do with legal indications as clinical ones.
There is some clinical evidence indicating a benefit to using both h1 and h2 blockers for symptomatic treatment of anaphylaxis. Read the paper a while ago, can dig it up if you would like?

Countering the release of histamine at the H2 receptors could help with GI, cardiac, and vasodilation aspects of anaphylaxis if my understanding is correct. Probably not necessary, but the data there is indicates it may be better than h1 blockers alone. I haven't seen any large scale and incredibly compelling RCT/studies to really sink the point home though. Hope that helps!
 

SpecialK

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There is some clinical evidence indicating a benefit to using both h1 and h2 blockers for symptomatic treatment of anaphylaxis. Read the paper a while ago, can dig it up if you would like?
They might help relieve symptoms but the definitive treatment is adrenaline so should be given first.
 

Fred weber

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What about dosing in this situation? Presumably we want to go higher than the standard dosage which is aimed more at hay fever and whatnot? Antihistamines have a pretty wide therapeutic index, I think... Depending on how deathly allergic he is, maybe have him take 5x the recommended dose on the package?

If all we have is PO, does it make sense to have him chew the tablets up for faster absorption?
First off I’m not a EMT in anyway. So a lot of the terminology mentioned is over my head .
Secondly
You guys can kick me off after this comment I’ll still be able to read the answer.

My grandson is allergic to bee venom so I’ve looked into this quite a bit.

Under the same circumstances as in the op “you’re 6 miles deep in the woods with no EpiPen and only Benadryl “.

From what I’ve read one of the main problems with Benadryl is that it takes to long to enter the bloodstream.

Absorption is very fast in the nasal passages . So the neophyte in me ask’s. Would administration that way be a good idea? If the airway is restricted it could be blown up their nose with a straw, hollow pen casing or something similar.

Thanks in advance

Worried grandpa
 

luke_31

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First off I’m not a EMT in anyway. So a lot of the terminology mentioned is over my head .
Secondly
You guys can kick me off after this comment I’ll still be able to read the answer.

My grandson is allergic to bee venom so I’ve looked into this quite a bit.

Under the same circumstances as in the op “you’re 6 miles deep in the woods with no EpiPen and only Benadryl “.

From what I’ve read one of the main problems with Benadryl is that it takes to long to enter the bloodstream.

Absorption is very fast in the nasal passages . So the neophyte in me ask’s. Would administration that way be a good idea? If the airway is restricted it could be blown up their nose with a straw, hollow pen casing or something similar.

Thanks in advance

Worried grandpa
We don’t give medical advice on this forum.
 

Gurby

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First off I’m not a EMT in anyway. So a lot of the terminology mentioned is over my head .
Secondly
You guys can kick me off after this comment I’ll still be able to read the answer.

My grandson is allergic to bee venom so I’ve looked into this quite a bit.

Under the same circumstances as in the op “you’re 6 miles deep in the woods with no EpiPen and only Benadryl “.

From what I’ve read one of the main problems with Benadryl is that it takes to long to enter the bloodstream.

Absorption is very fast in the nasal passages . So the neophyte in me ask’s. Would administration that way be a good idea? If the airway is restricted it could be blown up their nose with a straw, hollow pen casing or something similar.

Thanks in advance

Worried grandpa
Really this is a conversation that should be had with your grandson's physician / his parents. If he is at risk of having an anaphylactic reaction from a bee sting, he probably should have an EpiPen with him if he's going into the woods (or an adult should be carrying one).

If the airway is constricted or the person's blood pressure is dropping, Benadryl is unlikely to solve those problems even if you could have it be absorbed immediately.

For example: https://www.ncbi.nlm.nih.gov/pubmed/25141245
Although histamine is involved in anaphylaxis, treatment with antihistamines does not relieve or prevent all of the pathophysiological symptoms of anaphylaxis, including the more serious complications such as airway obstruction, hypotension, and shock.
 

DrParasite

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First off I’m not a EMT in anyway. So a lot of the terminology mentioned is over my head .
Secondly
You guys can kick me off after this comment I’ll still be able to read the answer.

My grandson is allergic to bee venom so I’ve looked into this quite a bit.

Under the same circumstances as in the op “you’re 6 miles deep in the woods with no EpiPen and only Benadryl “.

From what I’ve read one of the main problems with Benadryl is that it takes to long to enter the bloodstream.

Absorption is very fast in the nasal passages . So the neophyte in me ask’s. Would administration that way be a good idea? If the airway is restricted it could be blown up their nose with a straw, hollow pen casing or something similar.

Thanks in advance

Worried grandpa
As was said, we don't give medical advice here.

That being said, as a general rule, blowing any non-nasal medication up anyone's nose is not something I would do. if a medicine isn't designed by the manufacturer to go in a certain orifice, I'm not going to try something new just because of something I read on the internet. Just my general rule, not about your situation.

If you are that concerned, I would have a sit down with his pediatrician. He could give you some much better advice on what to do and what not to do.
 

Fred weber

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Really this is a conversation that should be had with your grandson's physician / his parents. If he is at risk of having an anaphylactic reaction from a bee sting, he probably should have an EpiPen with him if he's going into the woods (or an adult should be carrying one).

If the airway is constricted or the person's blood pressure is dropping, Benadryl is unlikely to solve those problems even if you could have it be absorbed immediately.

For example: https://www.ncbi.nlm.nih.gov/pubmed/25141245
Thank you sir
 

css

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Hi,
I found this thread with an online search after having a surprise allergy discovery.
And wanted to post an experiance with a situation in the same spirit as the original question(super old thread, I know) but you never know if the info might come in handy somewhere......

So, stung by bald faced hornets. (no history of any kind of allergy , I even kept bees for a few years! got stung every now and then) didnt think much of it, kept working in the yard.. a few minutes later...
I found myself alone at home having throuble breathing, lips swelling, heart pounding in my chest, a few other odd sensations, blurred vision etc...then as I get in the house Everything started to fade out and back in again....not good....

I was stung in the ear which was swelling up pretty good so I felt sure it was the sting. Found some benadryl in the bathroom, someone had left behind after a visit, took two and chewed them. ( I do not recomend this 😒...The flavor is pretty bad and it screwed up my sense of tase for a day or so....)

A few minutes later, back in the living room sitting down .... (Quick history, raised to never ever call 911 unless someone was going to die. "Your redirecting emergency sevices from someone else who might truly need it" was the standard saying ....grew up in very rural areas where help was limited over huge expanses ...) anyway, feeling like I was going to go down and not sure what would happen after that... I called it in ....after a minute or two and a transfer from dispatch and a little Q&A from local I started to feel the world stablize under me and felt bit clearer..heart ,breathing got a bit better ....I canceled the call, (dispatch was nice enough to try talking me out of it) and after a few, feeling fairly stable, I drove to the urgent care down the way....( please no" pass out at the wheel" lectures! I'm an overly responsible person and wouldn't dive unless certain...)

So did it help? I'm not sure where the raction rates on the severity scale .. .....and I am still not 100% sure that chewing made the difference , the MD seemed to think so... Followed by...."Its not a replacement for an epi pen though" ...
..The heart pounding and dizzy/faint feeling passed in minutes,breathing soon after, swelling took a bit and dose or two more.... But,It seemed to work.....

Sorry..... this was a reeeeally long response! And done at typo speed....
Thanks!
 

DrParasite

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I found myself alone at home having throuble breathing, lips swelling, heart pounding in my chest, a few other odd sensations, blurred vision etc...then as I get in the house Everything started to fade out and back in again....not good....
the symptoms you are describing are a classic anaphylactic reaction.
A few minutes later, back in the living room sitting down .... (Quick history, raised to never ever call 911 unless someone was going to die. "Your redirecting emergency sevices from someone else who might truly need it" was the standard saying ....grew up in very rural areas where help was limited over huge expanses ...)
well, considering you can die from an anapylactic reaction, calling 911 is likey appropriate.
anyway, feeling like I was going to go down and not sure what would happen after that... I called it in ....after a minute or two and a transfer from dispatch and a little Q&A from local I started to feel the world stablize under me and felt bit clearer..heart ,breathing got a bit better ....I canceled the call, (dispatch was nice enough to try talking me out of it) and after a few, feeling fairly stable, I drove to the urgent care down the way....( please no" pass out at the wheel" lectures! I'm an overly responsible person and wouldn't dive unless certain...)
and lets say you passed out behind the wheel.... or the symptoms returned and your throat started to swell up.... or your vision got blurry.... are you sure you weren't just lucky, because that could have easily gone another way, especially if you did pass out and causes a head on collision with a soccer mom, killing her and her 5 kids... would you like to tell her husband "but I was certain i could drive, I'm overly responsible!" That's also why we tell people not to follow the ambulance to the hospital, because people do weird stuff when they or their family members are sick. The drive of the ambulance is not as emotionally involved in the situation, and will not be affected by the patient's medical condition
So did it help? I'm not sure where the raction rates on the severity scale .. .....and I am still not 100% sure that chewing made the difference , the MD seemed to think so... Followed by...."Its not a replacement for an epi pen though" ...
..The heart pounding and dizzy/faint feeling passed in minutes,breathing soon after, swelling took a bit and dose or two more.... But,It seemed to work.....
Probably. the reaction you felt was likely a massive histamine reaction; taking an anti-histamine helped to reverse it.

Most allergic reaction protocols involve both benedryl and epi. But for a really bad reaction, epi will save your life, and benedryl will help you feel better.
 

css

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Interesting.....it seems you are simply being critical here ...just for the sake of having something to say.....

I didn't ask for a response or want one, I was simply relating an experience that resembled the original question.

A What if ...hiking in the woods ....no epi pen,only Diphenhydramine...

I'm from a very large extended east coast family, several generations, fire, police and medicine. I know the lay of the land.Hell, some of them were the true blue old guard, I mean the real deal, the men that the nubes would here stories about and eveyone would stand up straight and tall when they walked into a station.

I have a considerable amount of exposure to emergency situations and behaviors that result from stress. And personally, I have been under intense combative situations and been pushed to my extremes.I have an very clear idea of my physical limitations and capabilities...I have had the conversation you are talking about given to me and provided it on anothers behalf ...if you ever have the misfortune to give news of that nature to someone you will never again use that example, its not a toy to play with...

..... Just from your response here you are over confident which is more dangerous than just ignorant, the over confident guy or gal is most terrifying one to have your back in any situation.

Please take a moment and research... Your not exactly wrong but your a bit off on accuracy..... PLEASE DO NOT GOOGLE IT! Just a few seconds with a Merck manual...The Information may be critical at some point (sorry but you put Dr. In front of your name, even if its just an affectation in an online forum you should be 100% ...perfect in your information)

Sorry to be aggressive/ hit and run here...it sucks I know....I'm not interested in a Troll on Troll fight .... I know you will want to respond....and rightfully so, I threw a couple of stones at you...I'm going to respond or continue the thead...honestly I'm unlikely to even read your response....life is way to short ....
It was just a hypothetical question and I had real time experience that I wanted to relate, because you never know, someone might remember it when it fit their situation .....
 

Summit

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I didn't ask for a response or want one
And yet... here ya are...

Sorry to be aggressive/ hit and run here...it sucks I know....I'm not interested in a Troll on Troll fight
And yet... here ya are...

I have a considerable amount of exposure to emergency situations and behaviors that result from stress. Please take a moment and research...
Please state your healthcare education/licensure, and experience? We know DrP is an experienced fire medic with over a decade of practice. That doesn't make him always right, but what is your basis because you haven't actually pointed out factually errors, much less provided counterclaims, just insinuated that others need to bow to your experience and "research" and "read"?
 

DesertMedic66

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Interesting.....it seems you are simply being critical here ...just for the sake of having something to say.....

I didn't ask for a response or want one, I was simply relating an experience that resembled the original question.

A What if ...hiking in the woods ....no epi pen,only Diphenhydramine...

I'm from a very large extended east coast family, several generations, fire, police and medicine. I know the lay of the land.Hell, some of them were the true blue old guard, I mean the real deal, the men that the nubes would here stories about and eveyone would stand up straight and tall when they walked into a station.

I have a considerable amount of exposure to emergency situations and behaviors that result from stress. And personally, I have been under intense combative situations and been pushed to my extremes.I have an very clear idea of my physical limitations and capabilities...I have had the conversation you are talking about given to me and provided it on anothers behalf ...if you ever have the misfortune to give news of that nature to someone you will never again use that example, its not a toy to play with...

..... Just from your response here you are over confident which is more dangerous than just ignorant, the over confident guy or gal is most terrifying one to have your back in any situation.

Please take a moment and research... Your not exactly wrong but your a bit off on accuracy..... PLEASE DO NOT GOOGLE IT! Just a few seconds with a Merck manual...The Information may be critical at some point (sorry but you put Dr. In front of your name, even if its just an affectation in an online forum you should be 100% ...perfect in your information)

Sorry to be aggressive/ hit and run here...it sucks I know....I'm not interested in a Troll on Troll fight .... I know you will want to respond....and rightfully so, I threw a couple of stones at you...I'm going to respond or continue the thead...honestly I'm unlikely to even read your response....life is way to short ....
It was just a hypothetical question and I had real time experience that I wanted to relate, because you never know, someone might remember it when it fit their situation .....
TYFYS
 

DrParasite

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You know, I was gonna let it go.... but it's a slow day at work......
Interesting.....it seems you are simply being critical here ...just for the sake of having something to say.....

I didn't ask for a response or want one, I was simply relating an experience that resembled the original question.
you came here, and posted your story..... your experience is not invalid, however there are several things about it that I wanted to point out. Sorry your feelings were hurt.
A What if ...hiking in the woods ....no epi pen,only Diphenhydramine...
so pop as much Diphenhydramine until you fall asleep, especially if that's all you have.

how about this: What if ...hiking in the woods ....no epi pen, no Diphenhydramine, only dihydrogen monoxide... now what should you do? well, in that case, i'd say get as ampped up as possible, hope your body's natural fight or flight response kicks in (maybe challenge a bear to a wrestling match), and pray that your own adrenal glands dumps enough epinephrine into your system to stop the anapylactic reaction before your throat swells shut and you pass out. I mean, it's better than doing nothing, and just dying in the middle of the woods..... but it's also completely hypothetical, not all that realistic and has nothing to do with your story. Especially because in your "story," those that could have given you the epi were just a phone call away, but you didn't want them to come.
I'm from a very large extended east coast family, several generations, fire, police and medicine. I know the lay of the land.Hell, some of them were the true blue old guard, I mean the real deal, the men that the nubes would here stories about and everyone would stand up straight and tall when they walked into a station.
I'm sure your family is awesome. And if they were with you, they might even be able to give you some sound advice. Even better if one of your family members was an ER physician (which I am not). Heck, my great great great grandfather was in a general in the military, but that doesn't make me an expert in strategist for how to invade France.... Nor should anyone salute me when I walked into a station. but it's not really relevant, but it's cool that you have some awesome family members.
I have a considerable amount of exposure to emergency situations and behaviors that result from stress. And personally, I have been under intense combative situations and been pushed to my extremes.I have an very clear idea of my physical limitations and capabilities...I have had the conversation you are talking about given to me and provided it on anothers behalf ...if you ever have the misfortune to give news of that nature to someone you will never again use that example, its not a toy to play with...
not really relevant, but thank you for your service.
..... Just from your response here you are over confident which is more dangerous than just ignorant, the over confident guy or gal is most terrifying one to have your back in any situation.

Please take a moment and research... Your not exactly wrong but your a bit off on accuracy..... PLEASE DO NOT GOOGLE IT! Just a few seconds with a Merck manual...The Information may be critical at some point (sorry but you put Dr. In front of your name, even if its just an affectation in an online forum you should be 100% ...perfect in your information)
Hey, I'm not perfect.... if i'm wrong, feel free to explain why, and cite your source. You have 0 medical training, 0 medical education, and but you have family members in the know.... you'll forgive me if I don't just take your word for it.

I've even help you get started, from some people who are smarter and more educated than me:
Epinephrine: The Drug of Choice for Anaphylaxis--A Statement of the World Allergy Organization
https://www.foodallergy.org/about-fare/blog/know-the-difference-epinephrine-vs-antihistamines
https://allergynat.com/2017/11/11/the-correlation-between-benadryl-epinephrine-and-anaphylaxis/
https://www.aafp.org/afp/2003/1001/p1325.html
https://www.mayoclinic.org/first-aid/first-aid-anaphylaxis/basics/art-20056608
Sorry to be aggressive/ hit and run here...it sucks I know....I'm not interested in a Troll on Troll fight .... I know you will want to respond....and rightfully so, I threw a couple of stones at you...I'm going to respond or continue the thead...honestly I'm unlikely to even read your response....life is way to short ....
It was just a hypothetical question and I had real time experience that I wanted to relate, because you never know, someone might remember it when it fit their situation .....
ahhh, so you're just here to be a troll. at least you can admit it. Like I said, it's a slow day, otherwise I would just ignore you.

how about this: your story was exciting. you did some very dangerous things during a potentially life threatening medical emergency, which were dangerous because you didn't care about the potential consequences of your actions, or you were ignorant to the seriousness of your acute medical emergency. Did you survive? of course. could it have went another way? of course. if it had gone the other way, would you have died, and taken out several innocents with you? well........

I don't care If you don't read my response. Seriously, I don't (other than to learn where I was wrong, and read the sources you used to gain that information, since I can learn something new every day). What I don't want to happen is some other person who does read your initial post, and tries something that is potentially dangerous, because "some guy on the internet said it worked for him." Or some newbie EMS person says "we don't need epi (for this classic symptoms of an anapylactic reaction), the person I can just give the guy some OTC benadryl and he will be fine." Or even worse, some random person googles their symptoms, comes to your story, decides to just some benadryl and drive to urgent care, but deteriorates and crashes into my car, killing or injuring me or my family. That's what i'm trying to avoid.

But your a troll, so I'll let you go back to trolling.
 

Tigger

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Sorry to be aggressive/ hit and run here...it sucks I know....I'm not interested in a Troll on Troll fight .... I know you will want to respond....and rightfully so, I threw a couple of stones at you...I'm going to respond or continue the thead...honestly I'm unlikely to even read your response....life is way to short ....
It was just a hypothetical question and I had real time experience that I wanted to relate, because you never know, someone might remember it when it fit their situation .....
...turns out medicine isn't practice based on someone's personal experiences..
 

johnrsemt

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No one thought of the obvious answer: I always carried and use children's Benadryl. it is liquid so it absorbs fast, and it tastes ok.

Where I used to work the Medical Director wrote the protocols. So every county could have different protocols, although our medical director was the director for about 15 counties: So when I was working for the FD, in Indianapolis and a private service we had the same protocols (same medical director).

But when I went to work 2 summers at a Boy Scout Summer Camp as a Basic, our Medical Director was a GP doctor who wrote our protocols, with input from my partner and I; and our Medical Director and the Medical Director at the local hospital. We had about 30 OTC medications we could give, plus Epi 1:1,000; IM Diphenhydramine, Zofran ODT, and quiet a few others. But we were 35 miles from closest Medic truck and 45 miles from closest ED and 75 miles from closest helicopter. With 1,200 Scouts and leaders that changed every week.
We could also call the hospital when the blank hit the fan. The transporting medics bi***ed about the fact we had better protocols than they did.

Did the same type of thing with church camps and Scout Backpacking trips
 

Phillyrube

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I was cutting grass a few years ago and hit a yellow jacket nest. You know them...flying *** holes. I turned and ran to the house, running into a tree branch sticking out and cutting my nose. So I present to the wife with a bloody face and multiple stings on my leg. Forget the face, my leg is starting to swell. No known allergies, no breathing issues. Took 100 mg benadryl and fell asleep (SWMBO monitored). Woke two hours later, another 100 mg and more sleep. Everything returned to normal so chemical warfare ensued in the yard.

Had a normal check up the following week and mentioned this to my MD. I ended up with a scrip for epi pens after getting chewed out for being a "dang paramedics always treating yourselves."

Been stung since but no reactions.


"how about this: What if ...hiking in the woods ....no epi pen, no Diphenhydramine, only dihydrogen monoxide... now what should you do? "

Hey that crap is dangerous. Vapor form is really bad if inhaled.
 
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RedBlanketRunner

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maybe challenge a bear to a wrestling match
Definitely IV drip+.
I have a considerable amount of exposure to emergency situations and behaviors that result from stress. And personally, I have been under intense combative situations and been pushed to my extremes.I have an very clear idea of my physical limitations and capabilities..
Wildlife relocation expert outside Yosemite waking up to a playful cougar kitten landing on his chest: Oh look at the naked man doing the 3 minute mile through our campsite.
 
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