Allergic Reaction, Severe

What is a severe allergic reaction?

A severe allergic reaction is called an anaphylactic reaction. It is an immediate, severe reaction to a bee sting, drug, food, or other item. The symptoms begin within 30 to 60 minutes and are:

• Wheezing, croupy cough, or trouble breathing
• Tightness in the chest or throat (voice may become hoarse)
• Dizziness or passing out (skin may get bluish)
• Swelling of lips, tongue, or throat
• Widespread hives, swelling, or itching (if these symptoms occur without the symptoms listed above, your child is probably having an allergic reaction but not an anaphylactic reaction.)
• Vomiting, diarrhea, or stomach cramps

What should I do if my child has a severe allergic reaction?

1. Call 911 IMMEDIATELY.

   Call the rescue squad (911) if your child is having trouble breathing, trouble swallowing, or any other serious symptoms. Have your child lie down with the feet elevated to prevent shock. If your child stops breathing, start CPR.

2. Give epinephrine

   If you have an emergency kit with epinephrine (such as EpiPen), give a shot of it to your child immediately. It can save your child's life. Inject it into the muscle layer of the outer part of the upper thigh. Hold the needle in place for 10 seconds before pulling it out, so that all the epinephrine gets injected.

   Don't hesitate to give epinephrine. If there is any possibility your child is having symptoms of an anaphylactic reaction, give the epinephrine immediately. In addition, if your child had a life-threatening reaction in the past and now has been re-exposed to the same allergic substance (for example, peanuts, or bee sting), give the epinephrine BEFORE your child develops symptoms. Epinephrine will not hurt your child even if he is not having an allergic reaction and it could save his or her life.

3. Give albuterol inhaler

   If your child also has asthma, give 4 puffs of the asthma quick relief (rescue) medicine (usually an albuterol inhaler) immediately after you give epinephrine. Wait 1 minute between each puff.

4. Give an antihistamine

   If you have Benadryl at home, give it. If not, check if you have another antihistamine or cold medicine that has any antihistamine in it. If you do, give one dose immediately after calling 911 in addition to the shot of epinephrine.

5. Treat stings

   If a bee stinger is left in the skin, remove it. Do this by scraping the stinger off with a knife blade or credit card rather than by squeezing it.

What can I do to prevent an allergic reaction?

The only way to prevent a reaction is to AVOID contact with the food, drug, or other item causing the problem. It is very important to learn to read food labels.

All children with anaphylactic reactions need to be evaluated later by an allergist. For bee sting reactions, desensitization is helpful. Since the reactions can be fatal, you should keep emergency kits containing epinephrine at home, school, and in a backpack (or fanny pack). You will need a prescription. The allergist or your child's usual healthcare provider may prescribe epinephrine. In case of a severe reaction, epinephrine is needed immediately.

Educate others about your child's allergy (what your child needs to avoid, the symptoms of a reaction, and what to do if the child has a reaction). Tell all pharmacists, healthcare providers, and dentists who treat your child about any allergies he has. Some medicines contain ingredients that may cause an allergic reaction.

Also, your child should have a medical ID necklace or bracelet that tells the insect, drug, or food allergy. Some ID necklaces and bracelets can be found in pharmacies.