Using Epinephrine

Danger of Delayed Allergic Reactions

Danger of Delayed Allergic Reactions
child with clock
Anaphylactic reactions can occur hours after ingestion, even after experiencing mild or no symptoms initially.

Recently in my local food allergy support group, a brave mom – I’ll call her Mary – recounted the terrifying experience of dealing with her daughter’s delayed allergic reaction after eating peanut. This mom is brave for reliving those overwhelming emotions and for calling out her family’s mistakes to help educate other moms so their food allergic children stay safe.

Jenny, Mary’s daughter, was not at home and ate a bite of what she thought was a chocolate chip cookie as she read the ingredient list. Jenny realized the cookie didn’t contain chocolate chips but actually crushed up peanut butter cups. She quickly spit out the cookie but didn’t tell anybody what had happened.

A while later Jenny went home and her dad, after asking about her day and probing a bit into what he thought he was hearing, figured out she’d been exposed to peanut. He called Mary and she immediately headed home.

When Mary got home Jenny was in good spirits and talkative, though she was quite itchy. Mary gave Jenny a dose of antihistamine but didn’t panic and think epinephrine was needed because she thought if her daughter was going to have a severe reaction that it would have already occurred given the amount of time that had passed since accidental ingestion.

Mary decided a trip to the doctor was in order though so she drove Jenny to a walk-in clinic. When they got there the staff sprang into action and administered epinephrine and called for an ambulance to transport Jenny to the ER. Jenny was excited to ride in the ambulance and her demeanor was still upbeat and positive.

The EMTs arrived and after they got Jenny on the gurney and into the ambulance the EMT ordered a “slow roll,” meaning no lights or sirens since the patient wasn’t in distress. The ride to the ER was uneventful until the ambulance was about two blocks from the hospital. According to Mary, in the blink of an eye, something changed and Jenny got restless, then she became very pale and her eyes rolled up into her head. They rushed her into the ER, asked Mary one question – how much does Jenny weigh? – and they began working on Jenny. After more – a lot more, according to Mary – epinephrine and observation in the pediatric intensive care unit, Jenny was discharged and allowed to return home.

Lessons we can learn from Mary’s experience:

  • Talk to your child’s doctor to see whether epinephrine should be administered to your child in the case of known ingestion or even in the case of suspected ingestion and note such on the Food Allergy Action Plan (FAAP). For peanut allergies, most doctors recommend epi in the case of a known exposure, especially if your child has had a previous anaphylactic reaction to peanuts.
  • Know your child’s weight; keep the FAAP updated.
  • Don’t administer antihistamines as a substitute for epinephrine. An antihistamine’s effect on the body is not aggressive and is too slow acting. Don’t be afraid of the epinephrine auto-injector. Read Marketing Mama’s blog post about how she injected herself accidentally and it didn’t hurt.
  • After administering epi, call 911 for transport to the hospital. EMTs call the ER from the ambulance so a team is standing by and your child will be seen immediately. Driving yourself is both slow and dangerous.
  • The amount of epi in auto-injectors buys you time but may not be anywhere close to the amount of epi your child needs to stop the allergic response.
  • Reinforce with your older food allergic children the importance of reading the full ingredient list before eating anything.
  • Reinforce the importance of telling a grown up right away if they think or know they ingested their allergen.

I can’t express to Mary how much I appreciated her willingness to share what she learned. And I can’t imagine trying to manage my children’s food allergies without the help of other moms!

One Comment

  1. Jennell Ditucci

    Antihistamines are most commonly used to control the symptoms of allergies such as hay fever.In these conditions they work by preventing the actions of histamine, which is a substance produced by the body as part of its natural defences.”

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