Larger volume spacer - Asthma NSW | August 10, 2008 | Make sure you're getting the most out of your asthma medication by getting your inhaler technique right. This video shows the best way to use your Spacer.
- Always carry an EpiPen 2-Pak
- Always read food labels
- Ask questions about food preparation (be aware of the risk of cross-contamination)
- No label/no eat
- No EpiPen/no eat
- Tell friends about a serious food allergy
- Tell friends if feeling unwell, especially after eating
The action plans for food allergy and anaphylaxis include the use of EpiPen as first line of treatment.
Key points:
- There is no cure for food allergies at this time
- 8% of U.S. children under 18 have at least one food allergy
- Epinephrine is the first line life-saving medication in severe food allergic reaction. Always carry an EpiPen with you, and remember these simple memory rules in severe food allergic reaction:
- "No Epi, no eat-y" (always carry an EpiPen with you, don't sit down to eat if you don't have an EpiPen available)
- "If it's more than the skin, the Epi goes in" (only mild hives may respond to antihistamine, for anything else you may need an EpiPen)
Editor: V. Dimov, M.D., Allergist/Immunologist, Assistant Professor at University of Chicago
Saline nasal irrigation bathes the nasal cavity with liquid by instilling saline into 1 nostril and allowing it to drain out of the other nostril (typically, it drains from both nostrils and the mouth).
Pediatric Nasal Saline Flush/Rinse. Fauquier ENT | January 28, 2008 | This video shows a young child performing saline flushes to his nose without assistance. Indeed, kids older than 5 years are able to perform flushes without difficulty.
Adult Saline Sinus Rinse/Flush. Fauquier ENT | December 05, 2007 | Patient performing a saline flush to his nose. This procedure is often performed by patients who have chronic sinusitis or allergies.
Techniques and devices
Techniques and devices include:
- low positive pressure from a spray or squirt bottle
- gravity-based pressure using a neti pot or other vessel with a nasal spout
Indications
A range of conditions may respond to saline nasal irrigation but the evidence supporting its use is less conclusive:
The exact mechanism of action of saline nasal irrigation is unknown. Saline nasal irrigation may improve nasal mucosa function through direct cleansing; removal of inflammatory mediators, and improved mucociliary function, as suggested by increased ciliary beat frequency.
Adverse effects
Fewer than 10% of patients reported adverse effects:
- self-limited sensation of ear fullness
- "stinging" of the nasal mucosa
- rarely epistaxis
- Louisiana Department of Health and Hospitals warned against improper use following the deaths of two people who were infected with Naegleria fowleri after using tap water to irrigate their sinuses
Contraindications
Contraindications for saline nasal irrigation include:
- incompletely healed facial trauma
- increased risk for aspiration, such as intention tremor or other neurologic or musculoskeletal problems.
Recommendations
- For chronic rhinosinusitis, nasal irrigation is an effective adjunctive therapy (level of evidence, A).
- Limited evidence for effective adjunctive treatment of irritant or allergic rhinitis, viral upper respiratory tract infection, and postoperative care after endoscopic sinus surgery (level of evidence, B).
- rhinitis of pregnancy, acute rhinosinusitis, sinonasal sarcoidosis, and Wegener's granulomatosis (level of evidence, C).
Editor: V. Dimov, M.D., Allergist/Immunologist, Assistant Professor at the University of Chicago
How to use a nose spray
1. Gently blow your nose to clear it of mucus before using the medication. 2. Remove the cap and shake the bottle. 3. Hold the pump bottle with your thumb at the bottom and your index and middle fingers on top. 4. The first time you use the pump spray each day, you may have to prime it by squirting a few times into the air until a fine mist comes out. 5. Tilt your head forward slightly. Breathe out slowly. 6. Insert into the nostril and aim the nozzle toward the outside of the nose and away from the nasal septum (the cartiledge which divides our nose in half). 7. Squeeze the pump as you begin to breathe in slowly through your nose. 8. Repeat these steps for the other nostril. If you are using more than one spray in each nostril, follow all these steps again. Try not to sneeze or blow your nose just after using the spray.
Nosebleeds are among the most commonly reported adverse effect of intranasal corticosteroid sprays. However, they tend to result from incorrect positioning of the device ("hitting" the septum in the middle), rather than an adverse reaction to the medication.
Common errors to avoid when using a nose spray include the following:
- forgetting to prime the spray device; - skipping doses - wrong head position (should be tilted forward, not back) - pushing nozzle too hard or too far into the nose; - blowing nose hard after spraying (the medicine is lost) - sniffing hard after spraying (the medicine is deposited in the throat instead of the nose) - using saline sprays or irrigations after using corticosteroid spray, instead of before
- Always carry an EpiPen 2-Pak
- Always read food labels
- Ask questions about food preparation (be aware of the risk of cross-contamination)
- No label/no eat
- No EpiPen/no eat
- Tell friends about a serious food allergy
- Tell friends if feeling unwell, especially after eating
Eleanor Garrow, Vice President of Education and Outreach for FAAN, talks about living with food allergies, 2010.
FAANPAL | October 06, 2010 | A presentation of food allergy basics by Eleanor Garrow, Vice President of Education and Outreach for FAAN.
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