Allergy allies

Millions of children in the United States have allergies. In fact, allergies are responsible for about 2 million missed school days each year.

Most allergens are relatively harmless, but some can instantly trigger a severe, potentially life-threatening reaction.

To better manage these types of allergy emergencies, the American Academy of Pediatrics (AAP) recommends all caregivers of children who are at risk of severe allergic reactions have a new written action plan. This plan includes universal two-page form doctors can give to parents.

The AAP’s report also stresses that caregivers of these high-risk children should use epinephrine auto-injectors (EpiPens®) – not over-the-counter antihistamines – as the first course of treatment for anaphylaxis, a life-threatening reaction that disrupts breathing and causes a sudden drop in blood pressure.

“An action plan for anaphylaxis is nothing new for high-risk children and their families,” said James Waler, MD, a pediatrician with Baptist Primary Care. “But the AAP’s comprehensive template will help increase awareness of allergen risks and how to recognize and appropriately respond to severe reactions in children, should they be exposed.”

Plan of action

The action plan should be shared with anyone responsible for a child in his or her parents’ absence, such as caregivers at school, camp or any other setting where a child might encounter the problematic allergen.

In the two-page form, physicians should identify the following information:

• Name
• Date of birth
• Weight
• Allergen(s)
• Medication needed and directions for use
• Emergency contact information

The AAP action plan also includes a list of anaphylaxis symptoms and milder allergy symptoms, as well as clear instructions for how to respond to an emergency.

“What’s most important is that everyone is aware of the child’s allergy and how to recognize signs of a severe reaction,” said Dr. Waler. “I also recommend parents teach their child about the allergy in an age-appropriate way and how to be an advocate for his or her own health. A child should learn to notify an adult of his or her risk, how to avoid unwanted exposure to allergens and how and when to use an epinephrine auto-injector.”

Who’s at risk?

In order to determine if a child is at risk of an allergy emergency, parents will need to consult their pediatrician or allergist. The most common causes of anaphylaxis include allergies to:

• Cow’s milk
• Over-the-counter medications such as aspirin and ibuprofen
• Peanuts
• Shellfish
• Specific insect bites such as bees, fire ants or wasps
• Tree nuts like almonds, cashews and pistachios

Dr. Waler also mentioned a child might be at increased risk for anaphylaxis if he or she has moderate to severe eczema, asthma or a parent or sibling who has had a severe allergic reaction before.

Be prepared

“Anaphylaxis can begin in a matter of minutes after coming into contact with an allergen,” said Dr. Waler. “If not treated promptly and appropriately, the reaction can be life-threatening.”

Initial anaphylactic symptoms include:

• Chest or throat tightness
• Confusion
• Difficulty breathing or swallowing
• Itchiness
• Nausea or vomiting
• Rapid heart beat
• Skin redness
• Swelling in the face or neck
• Wheezing

If caregivers think anaphylaxis may be happening, they should follow the instructions on the child’s action plan, use an epinephrine auto-injector immediately and call 911.

An epinephrine auto-injector is the most effective treatment for anaphylaxis and should be administered within minutes of the onset of symptoms. The easy-to-use syringe of epinephrine, or adrenaline, is available by prescription only and comes in a pack of two, in case a second injection is needed. Parents and caregivers should keep two doses on-hand at all times.

A child’s allergist can provide instructions on how to use the epinephrine auto-injector and usually has demonstrators available for practice. An allergist can also assist parents in getting the most cost-effective device based on their insurance coverage.

If you suspect your child may have an allergy or be at high risk for a severe allergic reaction, make an appointment with a pediatrician at a Baptist Primary Care location near you or call 904.202.4YOU (4968).