There are few things that make me nervous in the ER anymore. After spending twenty plus years in nursing, I’ve seen and handled most everything.
I always love it when friend and author Dianna Benson stops by! Dianna is a talented writer and has two treats for you today– a new novel, Persephone’s Fugitive, is releasing. I was blessed to have the opportunity to read and endorse this novel. Two, she is giving a factually based fictional account of an EMS call dealing with a severe allergic reaction called anaphylaxis.
Welcome back, Dianna!
“Twenty-year-old female. Respiratory arrest.”
I grab the radio. “This is EMS 6, requesting assistance on our anaphylaxis call. Copy?”
“What is her name?” I ask no one in particular in the crowd of about a dozen surrounding us.
“Ally?” I rub my knuckles over her sternum.
“Unresponsive,” I inform my partner, who’s yanking out a BVM (bag-valve mask), other airway equipment, and the med box.
“What happened here?” I again ask the room full of people as I press the mask over my patient’s mouth and nose with my left hand in the E/C formation. With my right, I squeeze the football-sized bag every five seconds to oxygenate the young woman’s system. Her chest rises and falls with every squeeze, indicating her airway isn’t blocked by swelling or any foreign object.
I face the middle-aged woman, tears flowing out of her eyes and down her cheeks. “Are you her mother?”
Without an exchange of words, I hand one of the firefighters the BVM, and two of them take over bagging. One presses a tight seal over the mouth and nose, the other squeezes the bag.
I study the monitor for our patient’s vital signs, looking for indications of imminent anaphylactic shock and cardiac arrest. “BP 80/52. Pulse 134. SPO2 86%. Normal sinus heart rhythm.”
“Uh-huh,” my partner says, letting me know he heard my report of the grave vital signs.
My villain is going to kill his wife. She has a severe peanut allergy. My initial plan was for him to put peanut oil in a salad dressing, one that needs to be shaken to combine the oil and other ingredients. He also damages her epi pen. He does this right before he leaves town for business in order to give himself an alibi.
|Using Epi Pen|
He’s a professional athlete so news of his wife’s death will make media outlets like ESPN. I want initial news reports to say that it doesn’t seem to be foul play, even though it is.
Does that work?
The cause of death would be anaphylaxis. That’s how the person would die. Basically, an allergy causes a huge histamine release that can lead to cardiovascular collapse– difficulty breathing, low blood pressure, increased heart rate (tachycardia.) The reaction can get to the point where it can lead to death.
This is what your character would die from. So– the ME would be able to determine that the patient had an anaphylactic reaction. How easy it would be to pinpoint the exact cause of the reaction may be harder.
My follow-up question to Sally was: What’s to prevent the character from calling 911?
Death by allergic reaction does take a while. There is not set amount of time and my guess is it could be fairly expedient– perhaps 30 minutes for a person who is highly sensitive.
This is where the setting would come into play. In a city– the EMS response time should be 2-6 minutes. However, in the country where there may be only volunteer response, it feasibly could take 30 or more minutes.
The photo from this piece comes from a great article about whether or not to use epi pens.
Some free nursing advice for you here today– if you are a parent or adult and the thought comes to your mind– “Hmm– should I use the epi-pen?” Then yes, you should. Don’t wait. Don’t question it. Give it and either call 911 or go straight to the ER.
The issue with anaphylaxis is that it can spiral to a point where we cannot reverse the reaction and you may die. However, I’ve not yet seen a person die from giving themselves a single epi injection when perhaps they didn’t need it.
We’d rather monitor you alive for several hours than tell your family you’ll no longer be with them.
Sally Bradley has worked for two publishers, writing sales and marketing materials, sorting through the slush pile, and proofreading and editing fiction. She has a BA in English and a love for perfecting novels, whether it’s her work or the work of others. A judge in fiction contests, Sally is a member of ACFW, The Christian PEN, and the Christian Editor Network. She runs Bradley Writing and Editing Services from her home outside Kansas City. A mother of three, Sally is married to a pastor who moonlights as a small-town cop.