Medical student Miriam Al-Saedy knew a young girl was having a severe allergic reaction at a recent gathering of friends and family in Western Washington.
“Someone was yelling ‘Epi’ and I heard someone say ‘peanuts,’” recalled Al-Saedy, who’ll graduate next year from the Washington State University Elson S. Floyd College of Medicine. She grabbed her younger brother’s EpiPen out of the car and ran toward the commotion.
The young girl had hives and swelling on her face and said she was having trouble breathing, all signs of potentially life-threatening anaphylaxis. Al-Saedy got ready to inject the girl with epinephrine through the EpiPen, but the crowd tried to stop her, saying they’d already given the girl an oral antihistamine.
“It was definitely an intense situation,” Al-Saedy said, but at the same time, “it was a good lesson for me in, are you confident in your decisions?”
Al-Saedy injected the epinephrine and called 911. Because anaphylaxis can cause a sudden drop in blood pressure to dangerously low levels, and with no blood pressure cuff or other medical tools available, she also elevated the girl’s legs so they were higher than her head, called a Trendelenburg position.
“The things you learn in medical school, whether through patient experiences or case-based learning, really come in handy in real-life scenarios,” Al-Saedy said. “As one of my preceptors has said, MD stands for Making Decisions. I was confidently making decisions and seeing all my medical education come together.”
The girl recovered and later thanked Al-Saedy for her quick reaction.
Al-Saedy said the experience was also a lesson in what’s called EpiPen hesitancy.
Epinephrine is the gold standard in treating anaphylaxis, a condition that can cause death in 5 to 30 minutes if left untreated. People who have allergies to insect stings and foods are prescribed an EpiPen, which auto-injects epinephrine through a muscle.
But studies have found that people don’t use EpiPens when they should, and only about half of people who are advised to have an EpiPen on them at all times regularly carry one.
Reasons for EpiPen hesitancy include not being sure it’s needed, or mistakenly believing an oral medication will be enough. Some people don’t want to call 911 or visit an emergency room after using the EpiPen, which is recommended. And some people just don’t like the thought of using a needle, Al-Saedy said.
Because anaphylaxis can progress quickly to being life-threatening, and because each person’s symptoms are different, healthcare professionals tell patients that their default should be to use the EpiPen.
Al-Saedy said she will work on raising awareness of the dangers of anaphylaxis and EpiPen hesitancy as a doctor.
“It’s time to normalize anaphylaxis awareness and carrying EpiPens and training to use them,” she said. “Anyone can save a life in their communities.”
