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Emergency Hub

One-tap access to life-saving emergency information. Bookmark this page for quick reference.

Call 911 Immediately If:

Symptoms are severe, progressing rapidly, or the person is having trouble breathing, is turning blue, or has lost consciousness. Do not hesitate.

Anaphylaxis Symptoms

A severe, life-threatening allergic reaction. Symptoms can appear within minutes of exposure:

  • Hives, itching, or flushed/pale skin
  • Swelling of lips, tongue, throat, or face
  • Wheezing, shortness of breath, or coughing
  • Difficulty breathing or swallowing
  • Rapid or weak pulse
  • Dizziness, fainting, or low blood pressure
  • Nausea, vomiting, or diarrhea
  • Feeling of doom or confusion

Asthma Attack Symptoms

An asthma emergency requires immediate action. Watch for:

  • Severe shortness of breath
  • Chest tightness or pressure
  • Persistent coughing
  • Wheezing (whistling sound when breathing)
  • Retractions (skin pulling in around ribs/neck)
  • Difficulty speaking in full sentences
  • Rapid breathing
  • Blue/gray lips or fingernails (call 911 immediately)

When to Use Epinephrine

Use epinephrine immediately if:

  • Two or more body systems are affected (skin + breathing, gut + breathing, etc.)
  • Any difficulty breathing, throat tightness, or swallowing
  • Known allergen exposure with any symptoms
  • The person has a known history of anaphylaxis and symptoms appear

After using epinephrine:

  • Call 911 immediately — epinephrine is not a cure
  • Lie flat with legs elevated (or sit up if breathing is easier)
  • A second dose may be needed if symptoms don't improve in 5-15 minutes
  • Go to the ER even if symptoms resolve — biphasic reactions can occur

Key principle: It is safer to give epinephrine and not need it than to need it and not give it. Delayed use is the #1 risk factor for fatal anaphylaxis.

Interactive Body Map: Anaphylaxis

Tap any body region to see exactly what happens during anaphylaxis. If two or more regions react at once, use epinephrine immediately and call 911.

Airway & Lungs
  • Trouble breathing — short of breath
  • Wheezing — whistling sound when breathing
  • Tight or closing throat
  • Coughing that will not stop
  • Voice changes — hoarse or squeaky
  • Trouble swallowing

Throat closing or trouble breathing is a red-flag emergency. Use epinephrine now and call 911.

The rule: Anaphylaxis needs symptoms in two or more body systems — OR any one of: throat tightness, trouble breathing, fainting, or known allergen with symptoms. Use epinephrine first, then call 911.

How Anaphylaxis Affects the Body

Anaphylaxis is a full-body immune response that can strike multiple organ systems at once. Recognizing symptoms across every system is critical — reacting to two or more systems simultaneously is a strong signal to use epinephrine immediately.

Skin & Eyes
  • Hives or raised welts
  • Severe itching
  • Flushed, pale, or blotchy skin
  • Swelling of face, lips, or tongue
  • Watery, itchy eyes
Respiratory
  • Difficulty breathing or shortness of breath
  • Wheezing or coughing
  • Hoarseness or voice changes
  • Throat tightness or closing
  • Repeated sneezing or runny nose
Cardiovascular
  • Rapid or weak pulse
  • Sharp drop in blood pressure
  • Dizziness or light-headedness
  • Fainting or loss of consciousness
  • Pale or bluish lips/fingernails
Gastrointestinal
  • Nausea or stomach cramping
  • Vomiting
  • Diarrhea
  • Abdominal pain
Neurological
  • Feeling of doom or panic
  • Confusion or disorientation
  • Headache
  • Slurred speech

Use epinephrine right away if two or more body systems are involved, if there is any difficulty breathing, or after known allergen exposure with any symptoms. Then call 911 immediately.

Epinephrine Device Guide

Epinephrine devices — including auto-injectors and nasal sprays — are the first-line treatment for moderate to severe allergic reactions. Dosing is weight-based; your prescriber will specify the right strength. Each device delivers a single dose — always carry two.

After using any device:

  • • Call 911 immediately — epinephrine wears off in 10–20 min
  • • Keep the person lying flat (or upright if breathing is easier)
  • • Bring the used device to the ER for proper disposal
  • • A second dose may be given in 5–15 min if symptoms don't improve

General reminders:

  • • Injection site: always the mid-outer thigh
  • • Devices expire — check the date on yours now
  • • Each device is single-use only — replace immediately after use
  • • School, daycare, coaches, and family should know how to use yours

How to Administer Epinephrine

Epinephrine now comes in three delivery forms — auto-injector, nasal spray, and sublingual film. Each uses a different body site. Select a route below for clear written guidance on the correct site and step-by-step use.

Auto-Injector — what it is

A spring-loaded device that pushes a short needle into the mid-outer thigh to deliver epinephrine into muscle tissue, where it reaches the bloodstream fastest during anaphylaxis.

Correct site: Mid-OUTER thigh — never the buttock, inner thigh, hand, or any other area.

The outer thigh (vastus lateralis muscle) has a rich blood supply and little fat, so epinephrine reaches the heart and airways quickly. Injecting into fat (buttock) delays absorption and can be dangerous.

Step-by-step use:

  1. 1Form a fist around the device — orange/colored tip pointing DOWN.
  2. 2Pull off the safety cap.
  3. 3Press the tip firmly against the MID-OUTER thigh until it clicks.
  4. 4Hold for the time printed on your device (commonly 3–10 seconds).
  5. 5Remove and massage the area for 10 seconds.
  6. 6Can be given through clothing — do not delay to undress.

After ANY route: Call 911 immediately. Epinephrine wears off in 10–20 minutes, so emergency transport is always required — even if the person feels better. A second dose may be given if symptoms return or don’t improve within 5–15 minutes.

Disclaimer: This guide is for general educational reference only and is not a substitute for professional medical advice, training, or your prescriber’s instructions. Always follow the exact directions printed on your device and your healthcare provider’s guidance. In anaphylaxis, administer epinephrine first, then call 911 immediately.

Downloadable Visual Guides

Save these printable infographics to your phone or print them for school, home, and childcare.

FOOD ALLERGY

Signs & Symptoms of Anaphylaxis

Symptoms can appear within minutes of exposure

Hives, itching, or flushed/pale skin
Swelling of lips, tongue, throat, or face
Wheezing, shortness of breath, or coughing
Difficulty breathing or swallowing
Rapid or weak pulse
Dizziness, fainting, or low blood pressure
Nausea, vomiting, or diarrhea
Feeling of doom or confusion

If 2+ body systems affected → USE EPINEPHRINE → CALL 911

WHEN TO USE EPINEPHRINE

Don't hesitate — save a life

Use immediately if:

Two or more body systems affected (skin + breathing, gut + breathing, etc.)
Any difficulty breathing, throat tightness, or swallowing
Known allergen exposure with any symptoms
History of anaphylaxis and symptoms appear

After using:

Call 911 immediately — epinephrine is not a cure
Lie flat with legs elevated (or sit up if breathing is easier)
Second dose may be needed if no improvement in 5–15 minutes
Go to ER even if symptoms resolve — biphasic reactions can occur

When in doubt, use it. Delayed use is the #1 risk for fatal anaphylaxis.

ASTHMA ATTACK

Signs & Symptoms — Know Your Zones

Red Zone — Emergency

Severe shortness of breath at rest
Cannot speak in full sentences
Retractions (skin pulling in around ribs/neck)
Blue/gray lips or fingernails
Little or no relief from rescue inhaler

Yellow Zone — Caution

Wheezing or whistling sound when breathing
Chest tightness or pressure
Persistent coughing
Mild shortness of breath
Symptoms not fully controlled

Red zone → USE RESCUE INHALER → CALL 911 if no improvement

For reference only — not a substitute for professional medical advice. Always follow your physician's emergency action plan.

Biphasic Reactions — What You Need to Know

A biphasic reaction is a second wave of anaphylaxis symptoms that returns without another exposure to the allergen — typically within 4–12 hours after the initial reaction, though it can occur up to 72 hours later.

Why it matters:

  • Up to 20% of anaphylaxis cases have a biphasic phase
  • The second reaction can be milder, equal, or more severe than the first
  • It can happen even if the first reaction seemed fully resolved
  • Delayed epinephrine use increases the risk of a biphasic episode

What to do:

  • Always go to the ER after using epinephrine — do not assume it's over
  • Stay under medical observation for at least 4–8 hours after symptoms resolve
  • Keep a second epinephrine auto-injector on hand in case symptoms return
  • If symptoms return after initial improvement, use the second dose and call 911 again
  • Watch closely for 72 hours — inform family, school, and caregivers

Bottom line: Never self-discharge after anaphylaxis. Even if you feel 100% better, the second wave can strike hours later — sometimes without warning. ER observation is the safety net.

How to Use Every Type of Epinephrine

Step-by-step instructions for each FDA-approved epinephrine device. After ANY dose, call 911 and seek emergency care — a second reaction (biphasic) can occur hours later.

EpiPen / EpiPen Jr (and generic auto-injectors)

Auto-injector · 0.3 mg / 0.15 mg

  1. 1Form a fist around the EpiPen. Pull straight up on the blue safety cap to remove it — "blue to the sky."
  2. 2Swing and push the orange tip firmly into the middle of the OUTER thigh (at 90°). It can go through clothing.
  3. 3Push down hard and hold in place for 3 seconds (count slowly: 1… 2… 3).
  4. 4Remove straight out. Massage the injection site for about 10 seconds.

Never inject into veins, buttocks, fingers, toes, hands, or feet.

Auvi-Q

Voice-guided auto-injector · 0.3 / 0.15 / 0.1 mg

  1. 1Pull up to remove the outer case.
  2. 2Pull straight down to remove the red safety guard.
  3. 3Place the black end firmly against the middle of the outer thigh (through clothing is OK).
  4. 4Press firmly and hold — the device speaks step-by-step instructions, injects, and the needle auto-retracts. Hold for the full countdown.

Auvi-Q talks you through it — designed for any caregiver to use correctly under stress.

Symjepi

Prefilled syringe · 0.3 mg / 0.15 mg

  1. 1Push down on the plunger and turn to remove the cap (flip off the needle cover).
  2. 2Place the needle end against the middle of the outer thigh.
  3. 3Push the plunger down firmly until it clicks; hold for about 2 seconds.
  4. 4Withdraw and apply gentle pressure to the site.

Smaller footprint than EpiPen; needle is covered before and after use.

neffy® (epinephrine nasal spray)

Needle-free nasal spray · 2 mg (first FDA-approved non-injectable, 2024)

  1. 1Hold the device upright. Do NOT prime or test-spray it.
  2. 2Insert the nozzle into one nostril until your fingers touch your nose; keep it pointed toward your forehead, not up.
  3. 3Press the plunger down firmly until it clicks. Keep your head level (do not tilt back).
  4. 4If symptoms don't improve in about 5 minutes, use a second neffy in the OTHER nostril.

Needle-free — ideal for needle-averse patients and young children. Works even with a mild stuffy nose.

Anaphylm™ (investigational sublingual film) Awaiting FDA approval

Sublingual film · awaiting FDA approval

  1. 1A small dissolvable film is designed to be placed under the tongue.
  2. 2Close the mouth and keep it closed — do not chew, swallow, spit, or talk.
  3. 3Allow the film to dissolve completely; it delivers epinephrine directly into the bloodstream through the rich blood vessels under the tongue.
  4. 4This device is still in development and is NOT yet FDA-approved or available for use — continue using your prescribed epinephrine device.

Investigational — not yet approved. Anaphylm is a sublingual epinephrine film from Aquestive Therapeutics designed for rapid emergency treatment of anaphylaxis without a needle.

Common Asthma Medications

A verified reference of the most common asthma medication classes — what they do, common brand and generic names, and key safety notes. All information is sourced from federal health agencies and national medical organizations.

Short-Acting Beta-Agonists (SABA) — Rescue

Quick-relief

Examples: Albuterol (ProAir HFA, Ventolin HFA, Proventil HFA) · Levalbuterol (Xopenex HFA)

Relaxes airway smooth muscle within minutes to open the airways during an attack or before exercise.

Keep with you at all times. If you need it more than 2×/week (or >2 nights/month), your asthma may not be controlled — talk to your doctor.

Inhaled Corticosteroids (ICS) — Controller

Daily maintenance

Examples: Fluticasone (Flovent) · Budesonide (Pulmicort) · Beclomethasone (Qvar RediHaler) · Ciclesonide (Alvesco)

Reduces airway inflammation so attacks happen less often and are less severe. Taken every day, even when you feel well.

Rinse your mouth and spit after each dose to prevent thrush. The cornerstone of long-term control per NHLBI guidelines.

ICS / LABA Combinations — Controller

Daily maintenance

Examples: Fluticasone/Salmeterol (Advair, Airduo) · Budesonide/Formoterol (Symbicort, Breztri) · Mometasone/Formoterol (Dulera) · Fluticasone/Vilanterol (Breo Ellipta)

Combines an inhaled steroid with a long-acting bronchodilator for patients whose asthma is not controlled on ICS alone.

LABAs are NEVER used alone for asthma — they must be combined with an ICS. Some (Symbicort, Dulera) are FDA-approved as both maintenance AND rescue (SMART therapy) per your doctor.

Leukotriene Modifiers — Oral Controller

Daily maintenance / adjunct

Examples: Montelukast (Singulair) · Zafirlukast (Accolate) · Zileuton (Zyflo)

Blocks leukotrienes, chemicals that trigger airway inflammation and constriction. Taken as a pill, often for allergic asthma or exercise-induced symptoms.

Montelukast carries an FDA Boxed Warning for neuropsychiatric side effects (agitation, depression, suicidal thoughts). Discuss risks with your clinician.

Long-Acting Muscarinic Antagonists (LAMA)

Add-on maintenance

Examples: Tiotropium (Spiriva Respimat)

A long-acting bronchodilator added on for moderate-to-severe asthma not controlled on ICS or ICS/LABA.

Used as an add-on, not a first-line controller or rescue medicine.

Biologics — Severe Asthma

Specialist-administered

Examples: Omalizumab (Xolair — anti-IgE) · Mepolizumab (Nucala) · Reslizumab (Cinqair) · Benralizumab (Fasenra) · Dupilumab (Dupixent) · Tezepelumab (Tezspire)

Targeted monoclonal antibodies that block specific immune pathways (IgE, IL-5, IL-4Rα, TSLP) driving severe allergic or eosinophilic asthma.

For moderate-to-severe asthma not controlled by standard therapy. Given by injection or infusion by a specialist; can dramatically reduce attacks and steroid need.

Oral Corticosteroids — Exacerbation

Short-course rescue

Examples: Prednisone · Prednisolone (oral liquid for children) · Methylprednisolone (Medrol)

Powerful systemic anti-inflammatories used in short bursts (typically 3–10 days) to control severe asthma flare-ups.

For severe attacks only under a clinician's direction. Repeated courses carry significant side effects — a sign your asthma plan needs adjusting.

This reference is for educational purposes only and is not a substitute for medical advice. Always follow your prescribing clinician's instructions and your written Asthma Action Plan.

Visual Guide: How to Use Asthma Inhalers

Step-by-step visual walkthroughs for each inhaler type. Follow the numbered icons left to right.

Rescue Inhaler (MDI)

Albuterol · ProAir, Ventolin, Proventil

1

Shake

Remove cap. Shake inhaler 5–10 times.

2

Breathe Out

Sit upright. Breathe out fully, away from inhaler.

3

Press & Inhale

Seal lips around mouthpiece. Press down once while breathing in slowly & deeply (~5 sec).

4

Hold Breath

Hold breath ~10 seconds so medicine reaches your airways.

5

Wait & Repeat

If a 2nd puff is prescribed, wait ~1 minute, then repeat.

MDI with Spacer

Valved holding chamber · best for all ages & kids

Kid-friendly
1

Attach

Shake inhaler. Insert it into the back of the spacer.

2

Breathe Out

Breathe out fully. Place spacer mouthpiece in mouth (or mask over nose/mouth for kids).

3

Press Puff

Press inhaler once to release medicine into spacer.

4

Breathe In

Breathe in slowly & deeply, hold ~10 sec. (Kids: 6 normal breaths through mask.)

5

Wait & Repeat

Wait ~1 minute before 2nd puff if prescribed.

Dry Powder Inhaler (DPI)

Flexhaler, Diskus, Ellipta · controller medicine

1

Load Dose

Do NOT shake or breathe into device. Load dose per device (twist, slide, or open).

2

Breathe Out

Breathe out fully AWAY from mouthpiece (moisture ruins powder).

3

Inhale Fast

Seal lips. Breathe in FAST & deep — dry powder needs a forceful inhale.

4

Hold Breath

Hold ~10 seconds. Exhale away from device.

5

Close

Close/lock the device to prepare for next dose.

Emergency tip: If symptoms don't improve after your rescue inhaler, or you're in the red zone, call 911 immediately. A spacer is recommended for every MDI — it helps more medicine reach your lungs.

Asthma Medication Types

Know the difference between rescue and controller medicines — using the wrong one in an emergency can be dangerous.

Quick-Relief (Rescue) Medicines

Albuterol (ProAir, Ventolin, Proventil), Levalbuterol (Xopenex)

Relaxes airway muscles within minutes during an attack or before exercise. Keep with you at all times.

Controller (Long-Term) Medicines

Inhaled corticosteroids (Flovent, Qvar), combination ICS/LABA (Symbicort, Advair, Dulera)

Taken daily to reduce inflammation and prevent attacks — even when you feel well. Do NOT use for sudden symptoms.

Biologics (Severe Asthma)

Omalizumab (Xolair), Mepolizumab (Nucala), Dupilumab (Dupixent), Tezepelumab (Tezspire)

Injected/infused for moderate-to-severe asthma driven by allergic or eosinophilic pathways. Prescribed by a specialist.

How to Use Every Asthma Inhaler & Device

Step-by-step instructions for each delivery method. If symptoms are severe or not improving after your rescue inhaler, call 911 and follow your Asthma Action Plan.

Rescue Inhaler (Albuterol MDI — ProAir, Ventolin, Proventil)

Metered-dose inhaler (MDI) · quick-relief

  1. 1Remove the cap. Shake the inhaler 5–10 times.
  2. 2Sit upright and breathe out fully, away from the inhaler.
  3. 3Place the mouthpiece in your mouth and seal your lips around it. Press down once while breathing in slowly and deeply over about 5 seconds.
  4. 4Hold your breath for ~10 seconds to let the medicine reach your airways.
  5. 5If a second puff is prescribed, wait about 1 minute, then repeat.

Rinse your mouth after steroid (controller) inhalers — not needed for albuterol. Replace when the counter reads 0.

MDI with Spacer (Valved Holding Chamber)

Metered-dose inhaler + spacer · best for kids & all ages

  1. 1Shake the inhaler and insert it into the back of the spacer.
  2. 2Breathe out fully. Place the spacer mouthpiece in your mouth (or a mask over the nose/mouth for young children) and seal.
  3. 3Press the inhaler once to release a puff into the spacer. Breathe in slowly and deeply, then hold for ~10 seconds. (For small children: 6 normal breaths through the mask.)
  4. 4Wait ~1 minute before the second puff if prescribed.

A spacer dramatically improves how much medicine reaches the lungs and is recommended for EVERY MDI, especially children.

Dry Powder Inhaler (DPI — Flexhaler, Diskus, Ellipta)

Dry powder inhaler · controller / maintenance

  1. 1Do NOT shake or breathe into the device. Load a dose per the device (twist, slide lever, or open).
  2. 2Breathe out fully AWAY from the mouthpiece (moisture ruins the powder).
  3. 3Seal your lips around the mouthpiece and breathe in FAST and deep — dry powder needs a forceful inhale.
  4. 4Hold your breath ~10 seconds, then exhale away from the device. Close/lock it.

DPIs are breath-actuated — they need a strong, fast inhale. Not suitable for very young children or anyone who can't inhale forcefully.

Nebulizer

Compressor + mask/mouthpiece · for severe attacks or infants

  1. 1Add the prescribed medication to the medicine cup. Attach the mask (child) or mouthpiece, and connect tubing to the compressor.
  2. 2Sit upright. Place the mask snugly over the nose and mouth, or seal lips around the mouthpiece.
  3. 3Turn on the compressor and breathe slow, deep breaths until the mist stops (about 5–10 minutes).
  4. 4Rinse the mouth, then wash and air-dry the cup and mask per the instructions.

Best for infants, young children, and anyone unable to coordinate an inhaler during a severe flare.

Asthma Inhaler Training Videos

Watch recognized training videos from the American Lung Association, CDC, NEJM, and the Allergy & Asthma Network.

American Lung Association

How to Use a Metered-Dose Inhaler with a Valved Holding Chamber (spacer)

NEJM

Use of HFA Albuterol Inhaler — correct technique demonstration

Asthma Education (Module 3)

Using Inhalers — types, spacer use, and inhaler care

Live Air Quality Alerts

Real-time Air Quality Index (AQI) from U.S. EPA AirNow monitors, updated hourly. Especially important for anyone with asthma, COPD, or other respiratory conditions — check air quality before outdoor activity.

Leaflet © OpenStreetMap contributors

Current highest U.S. monitor: Corcoran, CA — AQI 104 (Unhealthy for Sensitive Groups). People in areas with AQI above 100 should take the precautions below.

AQI categories (EPA)

0–50Good
51–100Moderate
101–150Unhealthy for Sensitive Groups
151–200Unhealthy
201–300Very Unhealthy
301–500Hazardous

Guidance for respiratory conditions

Good: Air quality is satisfactory. Outdoor activities are safe for everyone, including people with asthma and COPD.

Moderate: Unusually sensitive people with asthma may consider reducing prolonged or heavy outdoor exertion.

Unhealthy for Sensitive Groups: People with asthma, COPD, and other respiratory conditions — plus children and older adults — should limit prolonged outdoor exertion. Keep rescue inhalers within reach.

Unhealthy: Everyone may be affected. People with respiratory conditions should avoid prolonged outdoor activity and stay indoors with clean air when possible; use reliever medications as prescribed.

Very Unhealthy: Health alert: sensitive groups should avoid all outdoor exertion. Everyone should significantly limit outdoor activity. Run air cleaners indoors.

Hazardous: Health warning of emergency conditions. Everyone should avoid all outdoor activity. People with respiratory disease should remain indoors and follow their emergency action plan; seek medical care if symptoms worsen.

1195 monitors shown · last reading 2026-09-12 05:00:00 GMT-4

Data: U.S. EPA AirNow. Values are preliminary and updated hourly; they are not fully validated and may change. This tool is informational and is not a substitute for medical advice or your asthma/COPD action plan.

Printable Action Plans from Trusted Organizations

Download the nationally recognized, ready-to-print emergency action plans directly from the medical organizations that publish them. Complete each plan with your healthcare provider and share copies with your school nurse, classroom teacher, and childcare provider.

Food Allergy & Anaphylaxis

FARE — Food Allergy & Anaphylaxis Emergency Care Plan

Food Allergy Research & Education

The nationally recognized fillable emergency care plan for food allergy and anaphylaxis, used by schools and camps nationwide.

Get printable plan

AAAAI — Anaphylaxis Emergency Action Plan

American Academy of Allergy, Asthma & Immunology

Printable anaphylaxis emergency action plan from the AAAAI, with space for allergens, symptoms, and treatment steps.

Get printable plan

ACAAI — Food Allergy & Anaphylaxis Resources

American College of Allergy, Asthma & Immunology

Patient education library with emergency action plan guidance and printable anaphylaxis resources.

Get printable plan

Asthma

AAFA — Asthma Action Plan

Asthma and Allergy Foundation of America

AAFA’s printable Asthma Action Plan with Green / Yellow / Red zones, completed with your healthcare provider.

Get printable plan

American Lung Association — Create an Asthma Action Plan

American Lung Association

Guidance and downloadable asthma action plan templates from the American Lung Association.

Get printable plan

NHLBI — Asthma Action Plan

National Heart, Lung, and Blood Institute (NIH)

The NHLBI’s official asthma action plan resource, the clinical standard referenced by schools and providers.

Get printable plan

Emergency Contacts

Save these numbers for quick access during an emergency.

Emergency Services911
Poison Control1-800-222-1222

This information is for reference only and is not a substitute for professional medical advice. Always follow your physician's emergency action plan.

While we strive for accuracy, information may change over time. Always double-check and verify against official sources before relying on it.

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Empowering advocates for allergy, asthma & anaphylaxis rights nationwide.

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Educational Disclaimer: The information on this platform is provided for general educational and informational purposes only. It is not medical advice and does not replace professional medical consultation, diagnosis, or treatment. Always seek the guidance of a qualified healthcare professional with any questions about a medical condition. If you are experiencing a medical emergency, call 911 immediately. While we strive for accuracy, please double-check and verify any information found here against official sources before relying on it.

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