By: Michael Pistiner, MD, MMSc, FAAP
Severe allergic reactions are unpredictable—they can happen anywhere, anytime. Symptoms can even go away with treatment and come back later. Parents of children with severe allergies to certain
foods,
insect stings, latex and medication know this all too well.
What's the plan when your child has an allergic reaction?
In an effort to best treat
anaphylaxis—a potentially life-threating, severe allergic reaction—the American Academy of Pediatrics (AAP) developed the clinical report, Guidance on Completing a Written Allergy and Anaphylaxis Emergency Plan. It explains how to create and use the latest AAP Allergy and Anaphylaxis Emergency Plan. This emergency care plan (ECP) is based on the most up to date and appropriate treatment of anaphylaxis.
Be better prepared for an allergic reaction emergency
In situations when you are not with your child, these written plans will also equip nurses, teachers, coaches, parents, relatives, babysitters and others who care for your child with the tools they need in the event of an emergency.
Download the AAP Allergy and Anaphylaxis Emergency Plan (PDF) here.
Epinephrine: first-line treatment for anaphylaxis
The AAP plan emphasizes the important role of epinephrine, which can quickly reverse symptoms of anaphylaxis. It takes emphasis off the role of antihistamines (such as diphenhydramine). The plan also lists symptoms of anaphylaxis and clearly tells the caregiver or child when to use the epinephrine.
Anaphylaxis emergency care plan overview:
Includes simple criteria to identify potential allergic emergencies for use by patients, families, school staff and all caregivers
Is accessible and understandable to anyone caring for your child
Is meant to be given to school, childcare, after-school programs, or any place where others care for your child
Trains others using your child's specific emergency care plan
When creating an emergency care plan, it is also important to customize it to the specific needs of your child, allergies, family and your state and local regulations. (Some may have their own forms already in place; you can encourage them to use this new one.)
If in doubt, give epinephrine!
In our report, the AAP also includes more evidence showing why:
- epinephrine is so important and safe
- delaying the use of epinephrine and relying on antihistamines is a bad idea!
Epinephrine is the first-line treatment for anaphylaxis because it works quickly.
Self-administered epinephrine is specially designed for easy use in non-medical settings. Delays in giving epinephrine for anaphylaxis can increase the risk of death, long hospitalization and a second anaphylactic reaction called a biphasic reaction.
Anyone caring for a child with an allergy that can be life-threatening must know how to recognize anaphylaxis and know when and how to give epinephrine. The
AAP Allergy and Anaphylaxis Emergency Plan and clinical report were designed to help with this—wherever your child is and whoever is caring for them.
What to remember about epinephrine
Epinephrine is the first-line treatment of choice for anaphylaxis
Acts where it is needed
Will make you feel better
Fast acting
Delays in administration increase risk of hospitalization or even death
Err on the side of caution and give if any doubt
Epinephrine is a safe medicine
More information
About Dr. Pistiner
 Michael Pistiner, MD, MMSc, FAAP, is a pediatric allergist and the Director of Food Allergy Advocacy, Education and Prevention at Mass General for Children, Harvard Medical School. He specializes in food allergy and anaphylaxis management in infants and toddlers. Dr. Pistiner's team proposed modified criteria for identifying anaphylaxis in young children and developed the Food Allergy Management and Prevention Clinician Support Tool for Infants and Toddlers (FAMP-IT.org). He has also been deeply engaged in school food allergy advocacy and education at the local, state and national level, having served as Chair of the Food Allergy Management in Schools Advisory Council and member of the CDC/USDA Workgroup for School Guideline Development for Managing Food Allergy in School. Dr. Pistiner is a member of the AAP Section on Allergy and Immunology and Council on School Health. |