Allergic Reaction: Severe

Anaphylactic shock, or anaphylaxis, is one of the scariest health emergencies a parent can face; it occurs when your child has a severe allergic reaction. When that happens, your child’s immune system mistakenly responds to a harmless substance as if it were a serious threat, triggering the release of histamine and other body chemicals that cause rapid and sometimes deadly symptoms, including these:

• Hives and swelling of the skin, lips, or face
• Wheezing or severe breathing problems
• Tightness in the throat or feeling like the throat is closing
• Rapid pulse
• Sweating
• Dizziness, fainting, loss of consciousness
• Nausea, vomiting, abdominal cramps, diarrhea
• Rapid loss of blood pressure
• Extremely pale skin

A wide variety of irritants can cause anaphylaxis in sensitive people, including these common triggers:

• Foods such as eggs, seafood, nuts, grains, milk, and peanuts
• Drugs such as penicillin
• Insect bites or stings
• Injected anesthetics
• Dyes used in diagnostic X-rays or scans
• Latex and other industrial substances

What should I do if my child suddenly goes into anaphylactic shock?

Call 911 immediately if your child is having trouble breathing or passes out. Have your child lie down with her feet elevated to reduce the risk of shock. If a bee has stung her, remove the stinger quickly by scraping it off with your fingernail, a knife, or any sharp edge.

If you have an anaphylactic kit, give your child an injection of epinephrine immediately. (It’s best to give the shot in the fat layer of the outer part of the upper thigh.) Even if you aren’t sure the reaction is anaphylaxis, give the shot — it could save your child’s life.

If you don’t have an anaphylactic kit but you do have Benadryl, give it to your child. If not, give her any antihistamine or cold medication you have that contains antihistamines. These help slow the runaway immune reaction.

Even if your child recovers quickly and seems to be normal, you should take her to the emergency room. Doctors there will probably want to keep her under observation for a few hours to be sure she doesn’t experience a second wave of symptoms.

Can anaphylactic reactions be prevented?

The best prevention is to avoid the substances that cause serious allergic reactions. If your child is allergic to certain foods, it’s important to ask at restaurants or friends’ houses whether a meal contains any of the allergy-provoking items. If insect bites or stings cause trouble, help your child find places to play that are bug-free.

Once your child has had a severe allergic reaction, your pediatrician may recommend that you keep an anaphylactic kit handy at all times. The most common kit, called Epi-Pen contains a preloaded syringe of epinephrine in a penlike instrument that’s easy to inject. Epi-Pen is available only by prescription (and some states do not allow nonmedical professionals to inject epinephrine). It’s wise to keep an extra kit in your purse, pocket, and the glove compartment of your car, since allergic reactions can happen anywhere and anytime.

Finally, once your child has a severe reaction like anaphylaxis, it’s important for her to wear a medical-alert ID necklace or bracelet (available in most pharmacies), which will alert healthcare providers in case of an emergency.

Robert H. Pantell M.D., James F. Fries M.D., Donald M. Vickery M.D., Taking Care of Your Child: A Parent’s Illustrated Guide to Complete Medical Care. Da Capo Lifelong Books.

Serious Allergic Reactions (Anaphylaxis) Nemours Foundation. http://kidshealth.org/parent/medical/allergies/anaphylaxis.html#

American Academy of Pediatrics, HealthyChildren.org. Anaphylaxis. http://www.healthychildren.org/English/health-issues/injuries-emergencies/pages/Anaphylaxis.aspx