A member of FAAN (the US Food Allergy Network - www.foodallergy.org) reported her own surprising reaction to her daughter's experience with a serious allergic reaction at school. We thought FM readers might find it useful. Although this advice is directed at the parents of allergic children, the recommended protocols apply to anyone suffering from an anaphylactic allergy.

My daughter, Aimée, has severe allergies to milk, eggs, tree nuts, peanuts and sesame. She also has asthma. Since she has been at school I have presented information to the staff about food allergies and the importance of using epinephrine early.

One day the school called me to say that while eating lunch, Aimée had been sick, had swelling of the lips, a rash on her arms and was wheezing. Aimée often vomits when she has a mild reaction and since she has eczema the rash did not bother me. The wheezing was my biggest concern but even that I rationalised away - she had had a cold the week before, so of course she would be a little wheezy.

I relied on the school director’s reassuring tone and said that I did not think it was necessary to use the Epipen or to call the ambulance.

I then went to the school to check on Aimée. When I got there and saw how lethargic she was I asked them to call the ambulance after all. Yet when the paramedics arrived she responded very alertly to their questions and I began to wonder whether I should have called them.

However, when we got to the hospital the allergist was not only sure that we should have called the emergency services but was upset that the Epipen had not been administered sooner.

So why had I not been willing to instruct the staff to use the Epipen? I know that epinephrine is not a dangerous drug. I realised that I had been more afraid of my daughter getting a shot (the thing she fears most of all) and being whisked off in an ambulance without me.

For the future, we have to learn that injections and ambulances are part of the life of a family which suffers from life-threatening allergies. As a family, therefore, we are going to get a tour of an ambulance and have a medical technician show us everything in a calm and informative way so as to minimise our anxiety.

FAAN's suggestions as to how you can be prepared

1. Have a food allergy action plan providing clear instructions on how to treat an allergic reaction and distribute copies to school officials.

2. Instruct the school staff to follow the action plan immediately - not to call you to assess the situation.

3. Teach those who care for your child not to hesitate to use the Epipen. Studies show that the sooner the epinephrine is administered during an anaphylactic reaction the better the outcome. You can get trainer pens to allow you to experiment with the pen.

4. Meet the local emergency services so that you know exactly what to expect if you do have to call an ambulance.

5. Do NOT assume that because the initial symptoms have subsided there is no need to call the emergency services. A second, or ‘biphasic', reaction can occur from one to four hours after the initial symptoms have gone away and these can be more severe than the first. After epinephrine is administered the patient should be observed for at least four hours.

Courtesy of FAAN - www.foodallergy.org

First published in 2005

If anyone has any comments that they feel would be helpful, please email them to info@foodsmatter.com, together with a link to this page, and we will add them here.

If you found this article interesting, you will find many more articles on anaphylaxis here, and reports of research into anaphylaxis here.
You can also find articles on peanut and tree-nut allergy here, cow's milk allergies here, egg allergy here, histamine intolerance hereand articles on a wide range of other allergic and intolerance reactions to a wide range of other foods here.

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