Mary and I had responded to a vehicle accident in late spring. None of the victims were injured, so we were getting ready to clear the scene and put ourselves available for another emergency call. I was sitting in the back of the ambulance filling out some paperwork, chatting with Mary.
She put her hand on the bench seat near the back door of the ambulance and felt a sting. She didn't say anything, but just looked at her hand. Mary quickly shook off the bee stinger and looked at me calmly. I was staring at her, trying to figure out what she was doing.
"We're out of service," she said, very matter of fact. "We need to go to the ER." When I didn't answer answer right away, she added quietly, "Now."
Mary pointed at the dead bee on the ground at her feet. I leaned out of the back of the ambulance to see it, and finally put it all together. She's allergic to bee stings. Not good.
"Let me give you some Epi," I said. Epinephrine is the treatment of choice for anaphylaxis. "Either that, or we can at least get you Benedryl to stop it until we can get to the ER." Benedryl® is an antihistamine that will slow - sometimes even stop - an allergic reaction.
Here's where it gets personal.
"No," she said. "Just take me to the hospital." Denied. It's like I'm not good enough to treat my own partner. Fine.
I drove, and Mary started to have a reaction. She sounded like she was clearing her throat - a common reaction when one's throat is closing.
"Sure you don't want me to give you some Epi?"
"I'm sure." Fine. Whatever.
I didn't use the lights and siren, since this wasn't an actual emergency call. I knew that, see, because she wouldn't let me actually treat her. Hmmmph!
Despite following all traffic laws, we made it to the emergency room in just a few minutes. By that time, Mary was making noise when she breathed. That's called stridor, and it comes from swelling in the airway below and around the voicebox (larynx).
I helped her into the emergency department through the ambulance entrance - one of the benefits of working here I guess. We surprised the nurses, but they quickly found her a bed in the ER. No one was available right away, so guess who started her IV...
The emergency department staff gave Mary epinephrine and diphenhydramine (Benedryl®) in the emergency department. It took a lot to get her reaction under control - three times what it would have taken in the field. By the time she was released from the ER, she was also given steroids to help with the inflammation caused by the anaphylaxis.
The Point of the Story
Time is not on your side during an anaphylactic reaction. The victim can develop a life-threatening reaction in seconds. Those who know they are prone to anaphylaxis (Mary included) often carry an epinephrine auto-injector (EpiPen®) with them. After getting the stinger out right away - which Mary did - victims need to get the epinephrine injected as quickly as possible - which Mary didn't.She's a good partner. Luckily, she's still around to work with me. In the future, she's promised to take her epinephrine immediately - and to stay away from bees!
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