Treatment of Anaphylaxis | When to Give EpiPen

If you suspect that a child with a severe food allergy may have accidentally eaten some of the food they are allergic to, do you give them a shot of adrenaline? If they don’t have any of the symptoms of anaphylaxis, should you wait and see or go ahead and give them the adrenaline?

Many people would find it difficult to give a shot of adrenaline to a child that seems ok just on the suspicion that they have ingested an allergen.

In the case of Natalie Giorgi, a thirteen-year-old girl from California who had a severe peanut allergy, there were no apparent symptoms after she accidentally bit into a rice krispie treat made with peanut butter for about 20 minutes. When she realised the treat had peanut butter in it, she spit it out and went to tell her mother.

Her parents monitored her for symptoms, but after 20 minutes she vomited and experienced shortness of breath. Her father, a physician, then administered the first of 3 EpiPens and gave her oxygen. Unfortunately Natalie was in anaphylactic shock, went into cardiac arrest and died before she could get to a hospital.

The mean time between when a person eats a food they are allergic to and when they enter cardiovascular or respiratory arrest is 30 minutes. In these cases, there is very little time for action after the person displays even mild allergic symptoms.

On the other hand, there are children and adults who experience some mild symptoms such as itching in their throat or nausea after eating, but recover without being given adrenaline.

This happens regularly enough to cause debate even amongst allergy doctors who see it happen frequently at allergy challenges. Though adrenaline is the front line treatment for anaphylaxis, there is some debate as to when it should be given.

Should you give the adrenaline shot or wait and see?

There is an understandable unwillingness to administer adrenaline or sound the alarm until the symptoms worsen and it becomes clear that the child is experiencing anaphylaxis, however these delays in treatment can lead to fatalities.

Giving adrenaline straight away may seem aggressive but it may ultimately be the safer option.

Source: https://www.aaaai.org/ask-the-expert/when-administer-epinephrine

Image: Flickr/ U.S. Dept of Agriculture under creative commons licence

Disclaimer: The information provided is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis or treatment. Allergy Lifestyle Limited (t/a) Allergy Lifestyle) uses reasonable endeavours to check the accuracy of information provided however no warranty is given that they are error-free. Always seek the advice of an allergy specialist and follow your anaphylaxis emergency care plan.