These two patients could not have been more different in their attitudes to what was happening to them. Each presented with several hallmark signs of Anaphylaxis. Hopefully they had the same outcome. For one of them, I'll never know.

Case One: Olivia was a twelve year old kid, in her last year of primary school. She'd been away for the weekend with a group of friends (and two mothers), and they'd been camping near the pharmacy I was working at. It's early in the afternoon, and I'm dealing with an lady who has some mild intellectual impairment who has fallen over. I've just seen off an ambulance. They were going to deal with the blood dripping from her head and her altered mental state. She'd actually fallen over twice. The second time was down her front steps, on the way to the 24hr medical centre about the first fall. Hmph. Anyway, in bustles one of the parents with Olivia.

Olivia is very pink in the cheeks. She's sweating profusely, and I can see hives across her neck and upper chest. I quickly ask how long she's been like this, and it's been about ten minutes. She's never had anything like this before. Olivia doesn't have no known allergies, but she's sure as eggs allergic to something. She's deteriorating before my eyes. I get her some ventolin. Olivia says to the helper that she's really scared. For the second time in half an hour, I call the ambulance. I tell them that there's a case of suspected anaphylaxis. The ambos rock up inside four minutes, and whisk her off to the local hospital. The pharmacy gets a call the next day; Olivia's okay. Neither she nor her docs can pinpoint the allergen.

Case Two: It's 6pm on a Sunday and the pharmacy is packed. Like, thirty people and twenty 'scripts packed. The automatic doors whir again and I look up. A kid about 18 swaggers in. He's only wearing white boardies and a cap. Everyone stops what they're doing and just stares at this kid. He is red as a beetroot from the umbilicus to his eyeballs. One of the ladies waiting gasps in horror.

"How long have you had that?", I ask from about 20m away, as I put down the script in hand.
"Oh, about five minutes, I just need some cream for it."
"Have you been coughing since that came up?"
"Yeah, a bit. My hayfever's a bit shit."
"Mate, you're having an allergic reaction, you've gotta go to hospital now."
"Nah, just gizzus a cream."

Then he starts coughing. His girlfriend has run in behind him, and she's worried. Rightly so.

"Listen to the man!" She says.
"Nah, it's just a rash. What about those" cough, cough "antihistamine tablets."
"There's nothing I can sell you that'll help, but I'll call an ambulance for you. What's you name?"
"None of ya business!"

A septagenerian waiting patiently touches his arm and says;
"Sonny, you look in a bad way. If he pharmacist says you're in trouble you need to listen to him."

"I'm fine, aye." cough "I just want some cream..."
"Look chief, if you don't get to hospital in the next fifteen minutes, you're gonna die. You're coughing because your throat's closing up. I'm not kidding here."
"Aw, F*** ya then." And he walks out.

The girlfriend has decided to listen. She asks, quickly, how long I reckon he's got. I impress the importance of getting the guy to hosptial now. She looks worried, and runs out, shouting "Jaaaames....." She takes his keys and gets in the driver's side.

They drive off. I really hope they went straight to the hospital.

Next on Tales of Anaphylaxis: Part III: How to spot it and The Worst Case Scenario