According to the Allergies and Asthma Foundation of America (AAFA), allergies are the sixth leading cause of chronic illness in the United States. Food allergies send 90 million people to emergency rooms each year with a life-threatening allergic reaction called anaphylaxis. Other common anaphylactic triggers include medications and insect stings. Asthma, a leading chronic disease in children, can also be triggered by common allergens, including pollen, pet dander and certain foods.
Unless your child has already been diagnosed with an allergy or asthma, you may not recognize the potential severity of their symptoms right away, especially if they haven't experienced them before. With a severe allergic reaction, this can be fatal.
Life-threatening allergic reactions can happen rapidly and without warning. They can even be triggered by things your child was previously able to tolerate. For example, the American College of Allergy, Asthma and Immunology (ACAAI) reports that it's not uncommon to have a "normal" reaction to an insect sting the first few times and then experience increasingly severe reactions with each subsequent sting.
When to go to the ER for an allergic reaction
Dealing with a severe allergic reaction can be frightening, especially when it's your child who is affected. According to the CDC, food allergies are a growing food safety and public health concern that affects about 1 in 13 children, or about 2 students per classroom. Avoiding the allergen trigger is the only way to prevent a reaction.
Two of the main allergic reaction signs that should send you running to an emergency room or calling 911 include:
- Hives (itchy, raised, red or skin-colored welts) all over the body
- Breathing problems
Some symptoms of allergies and allergic reactions can mimic other conditions, such as colds and flu. To complicate matters further, kids with asthma also often have allergies. For that reason, it's important that your child's asthma be well controlled.
If you're unsure whether your child is having an asthma attack or a severe allergic reaction, try to identify what happened right before symptoms began. Did your child swallow a medicine, eat a specific food (the most common trigger in kids) or get stung by an insect? These would all point to anaphylaxis. If that doesn't clear things up, the AAFA recommends that you:
- Use your child's epi-pen first, as it treats both anaphylaxis and asthma
- Follow with an asthma quick-relief inhaler
- Call 911 and go to the hospital via ambulance
Always call 911 if you think someone is having a life-threatening medical emergency.
Anaphylaxis
The most severe allergic reaction is anaphylaxis, which occurs when the body releases an overdose of allergen-fighting chemicals. If left untreated, anaphylaxis can lead to anaphylactic shock (a sudden drop in blood pressure and narrowing of the airways), seizures, cardiac arrhythmia and even death.
Additional symptoms of a severe allergic reaction that require immediate medical attention include:
- Abdominal pain, vomiting, intense nausea or diarrhea
- Chest tightness
- Feeling of doom
- Light-headedness
- Skin reactions or discoloration (rashes, flushed, blue, pale)
- Swelling of the eyes, mouth, tongue or throat
- Tingling hands, feet, mouth or scalp
- Weak, rapid pulse (heartbeat)
If your child has an epi-pen, use it at the first sign of an anaphylactic reaction. Call 911 and then go to the hospital by ambulance — even if your child feels better. You must seek medical care immediately because symptoms can recur.
Get tested and give it a shot
If your child is having reactions that can't be controlled with medications or other forms of treatment, you may want to schedule allergy testing so you'll know exactly what their triggers are.
Your pediatrician, allergist or immunologist may then suggest allergy shots, most commonly used to treat hay fever, allergic asthma and insect stings. Allergy shots don't work for everyone and they're not used to treat all types of allergies, such as food allergies.
Epi-pens are often prescribed for food allergies — as well as for those caused by insects, medications and latex. This is a prefilled, pen-sized device containing liquid medication (epinephrine) that works to relax the muscles of the airway at the first sign of a serious allergic reaction.
The ACAAI recommends that people who have a known or suspected allergy to insects should carry at least one self-injectable epi-pen at all times — and two for those who have had a past severe allergic reaction.
Keep in mind that an injection is like first aid for an allergic reaction: it's a great first line of defense and can save your child's life, but it doesn't take the place of medical treatment. Be sure to call 911 or get to an emergency room after using the injection.
EIRMC offers specialized, expert pediatric emergency care in Eastern Idaho.
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