Travel Reference
In-Depth Information
withextensive, disablingurushioldermatitis requiresystemic steroidtherapy.Inurbansur-
roundings such persons have been defined as those sick enough to seek a physician's care;
the physician should prescribe the appropriate medication.
According to its manufacturer, Zanfel®, a recently developed product, binds with the
urushiols that cause the rash, removes them from the skin, and relieves symptoms in thirty
seconds. To use this product the area of dermatitis should be wet with water. A 1.5-inch
strip of the cream should be squeezed onto one palm, and the hands should be wet and
rubbedtogetherfortensecondstoworktheproductintoapaste.Thenbothhandsshouldbe
rubbedontheaffectedarea,workingtheproductintotheskinuntiltheitchingstops,which
usuallytakesonlyaboutthirtyseconds.Finally,theareashouldberinsedthoroughly.Ifthe
itching returns the application can be repeated.
Desensitization for poison ivy has been tried, but the side effects are as bad as the rash.
No desensitizing agent has been approved by the Food and Drug Administration (FDA).
Many over-thecounter preparations for poison ivy contain antihistamines, analgesics, or
even antibiotics that can produce a secondary allergic reaction that may be worse than the
original problem.
ANAPHYLACTIC SHOCK
Anaphylactic shock is an acute, severe allergic reaction that involves essentially the entire
body. Fortunately, such reactions are not common, for death can occur within five to ten
minutes if treatment is not administered immediately—nor are they rare. An estimated 500
to 1000 fatal anaphylactic reactions occur each year in the United States. Deaths due to
anaphylactic reactions undoubtedly still go unrecognized, are attributed to heart attacks or
similar disorders, andmay besignificantly more common than appreciated. The number of
milder reactions is much greater but cannot be accurately determined because no precise
definition of the syndrome has been accepted. Some physicians only diagnose severe reac-
tions as anaphylaxis, although others include milder disorders.
The causes of anaphylactic shock likely to be encountered in a wilderness situation are
food allergies, drug reactions, and insect stings. Food allergy was responsible for one-third
of the anaphylactic reactions in individuals presenting to the emergency room at the Mayo
Clinic. The foods that most commonly cause food-induced anaphylaxis are peanuts; tree
nuts such as pecans, walnuts, and almonds; and shellfish, but a wide variety of foods has
caused such reactions.
Drug reactions are an equally common cause of anaphylaxis. Most such reactions are
caused by penicillins or cephalosporins that have been injected, although orally inges-
ted drugs occasionally cause them. An estimated 1 in 5000 penicillin injections results in
anaphylaxis. Foreign serums, such as horse serum-based antivenom used to treat venom-
ous snakebites, cause anaphylaxis in approximately one-fourth of the individuals receiving
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