What is anaphylactic shock, what happened to Karanbir Cheema and how can it be reversed?
KARANBIR Cheema, 13, collapsed and died after going into anaphylactic shock when cheese was thrown at him at school in June 2017.
What causes the body to go into anaphylaxis - and can it be treated?
What is anaphylactic shock?
Anaphylactic shock is a severe and potentially fatal reaction to a trigger such as an allergy.
It normally comes on suddenly, and gets worse very quickly.
Symptoms include:
- Feeling lightheaded, dizzy or faint
- Fast or shallow breathing
- Wheezing
- A fast heartbeat
- Clammy skin
- Confusion and anxiety
- Collapsing or losing consciousness
A sufferer may also display symptoms of allergies, such as an itchy raised rash (hives), feeling or being sick, swelling or stomach pain.
What happened to Karanbir Cheema?
Karanbir Singh Cheema, known as Karan, went into anaphylactic shock when cheese half the size of a Post-it note landed on his skin at his school in Greenford, West London.
The 13-year-old died from an "extraordinary reaction" when the cheese was flicked at his neck by another pupil in a "childish and thoughtless act," an inquest heard this month.
Senior coroner Mary Hassell recorded a narrative conclusion into his death, and said the main factor was his severe allergy.
She called for schools to better educate pupils to the dangers of allergies and for care plans for children with allergies to be beefed up.
Karan was severely allergic to wheat, gluten, all dairy products, eggs and nuts and he was also asthmatic and suffered from atopic eczema.
A boy threw the cheese at Karan who went into anaphylactic shock in June 2017.
It took just under ten minutes for the teen to go from being "absolutely fine" to unconscious.
Unknowingly, staff at the school administered an epipen that was an entire year out-of-date because of a spreadsheet error.
Karan, who was still unconscious when paramedics arrived at 11.49am, was taken to Northwick Park Hospital in Harrow and then transferred to Great Ormond Street Hospital (GOSH) in central London.
But he never regained consciousness and died ten days later on July 9 with his family by his side.
An allergy expert told the inquest he had never seen another case of a patient dying just through skin contact with an allergen and described Karan's death as "unprecedented" in medical circles.
What causes anaphylactic shock?
Anaplylaxis occurs when the immune system over-reacts to a trigger.
This is normally, but not always, because of allergies.
In some cases, there's no obvious trigger. This is known as idiopathic anaphylaxis.
Common triggers of anaphylactic shock:
- Foods: nuts, milk, fish, shellfish, eggs and fruit
- Medicines: antibiotics and non-steroidal anti-inflammatory drugs such as aspirin
- Insect stings: particularly from wasps and bees
- General anaesthetic
- Contrast agents: special dyes used in some medical tests to help certain areas of your body show up better on scans
- Latex: a type of rubber found in some gloves and condoms
How can anaphylactic shock be reversed?
If you see someone with symptoms of anaphylaxis, here are the five things you should do straight away, according to the :
- Call 999 immediately
- Use an adrenaline auto-injector (EpiPen) if the person has one: but only after reading instructions/if you already know how to use it
- Carefully remove any trigger: e.g. a wasp or bee sting stuck in the skin
- Lie the person down flat: unless they are unconscious, pregnant or having breathing difficulties
- Give another injection of the EpiPen after five to 15 minutes if the symptoms don't improve, and a second auto-injector is available.
After an anaphylactic shock, the patient will need to go to hospital for between six and 12 hours, because the symptoms can reoccur during this period.
They may be given an oxygen mask to help breathing, fluids to increase blood pressure, and antihistamines or steroids to help relieve symptoms.
If the patient doesn't already have an EpiPen, they may be given one before they go home.
If you have ever had a serious allergic reaction or gone into anaphylactic shock before, you should:
- Identify and avoid any triggers
- Carry your adrenaline auto-injector (EpiPen) at all times
- Give yourself an injection if you think you are experiencing anaphylaxis, even if you are not completely sure.
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