Dealing with Emergencies

Being prepared

Have a written Anaphylaxis Emergency Plan with a picture of your child. Post this plan in a place where you can see it and have a copy available at all times. Any person caring for your child should have a copy. It will be useful to refer to during an emergency. Ask your doctor to help you fill out a copy and explain the emergency steps. You should be able to recognize the symptoms of anaphylaxis and treat your child with an auto-injector.

Learn to use your child’s auto-injector. Talk to your child’s doctor about when and how to use it. Each brand of auto-injector has a website with instructions and videos to help you learn how to use the device. Practice with a training device, which looks like a real auto-injector but does not contain a needle or the drug. This will help you prepare for an emergency and feel more confident about using the auto-injector.

Keep an emergency plan and epinephrine auto-injector with your child at all times.

Always have your child’s auto-injector available. If you forget to bring it with you, go home and get it. It is wise to have two doses of epinephrine with your child, because some people may need a second dose during a reaction. Discuss this with your doctor.

Use medical identification jewelry, such as MedicAlert®. If your child is alone or is unconscious, the identification jewelry gives others credible information about their allergy.

If there is an emergency

If you think your child is experiencing an anaphylactic reaction, follow the steps of the emergency plan. Talk to your doctor about when and how to use your child’s auto-injector.

Remember that epinephrine is the first line treatment for anaphylaxis. This is the medicine of choice for a severe allergic reaction. It works quickly and helps to treat life-threatening symptoms by opening up the airways and increasing blood pressure. Deaths from allergic reactions to foods are rare, but the risks are real and need to be taken seriously. In most cases, deaths from allergic reactions to foods have been caused by a delay in treatment with epinephrine.

Contact emergency services. Call 9-1-1 (or the emergency service in your area) and stay with your child while waiting for the ambulance. Get another person to show paramedics where your child is. Do not make your child stand up or walk to the ambulance.

Place your child on their back with their legs raised while waiting for the ambulance. This position will help the blood flow to the vital organs of the body (heart, brain and lungs) and help to reduce the symptoms of shock.

If your child is vomiting (throwing up) or feels nauseated, place them on their side (recovery or semi-prone position) so that if they vomit, they will not choke. It is very important to keep their airway clear.

If your child is finding it difficult to breathe, they may prefer to be in a sitting position. However, if breathing is not an immediate concern, keep them lying down as described above and do not move them suddenly into a sitting or standing position until a doctor can assess them. Sudden movement into an upright position during an allergic reaction can cause a drop in blood pressure, which can be dangerous.

A second dose of epinephrine can be given as early as 5 minutes after the first dose if there is no improvement in symptoms. Keep in mind that epinephrine can wear off, and your child may need more epinephrine, as well as other treatments. It is important that your child is taken to the emergency department to be seen by a doctor. A second wave of anaphylaxis is called a biphasic reaction. This happens after the initial symptoms are resolved and is usually several hours after the first reaction.

The paramedics should take the child to the ambulance by stretcher.

Stay calm. Your child will feel less anxious if they see that you are in control.

Ask the doctor to prescribe auto-injectors before leaving the hospital. Purchase the auto-injectors as soon as possible.

Deaths from anaphylaxis are rare and most can be avoided. Epinephrine works the best when given early. It can be dangerous to wait to give epinephrine.

Learning from a reaction

When your child has a reaction it can be very stressful for both you and your child. Try to learn from your experience.

If possible, speak with the people involved and let them know that you appreciate their support in helping your child. Discuss what went well and what could be improved. Taking steps to improve emergency procedures will help to better protect your child.
Sometimes people get excited during an emergency, raising their voices or crying.
Let your child know that they didn't do anything wrong and that no one was angry with them.
Try to answer your child’s questions in a way that they can understand. You don’t have to have all the answers. It is fine to tell your child that you need to think about their question, or ask the doctor, and then get back to them with an answer. Remember, if your child feels that a topic makes you uncomfortable, they will keep questions to themselves and make up their own answers, which may cause unnecessary fear.
Make an appointment to see your child’s allergist to review the allergic reaction and the emergency plan.
Think about speaking with a mental health professional if you are feeling extremely anxious about the reaction.

Teaching children

Teach your child about the possible symptoms of an allergic reaction.

Tell your child to talk to an adult immediately if they think they may have accidently eaten an unsafe food or feel any symptoms of an allergic reaction.
Let your child know that you keep their emergency medicine close by. If they have an allergic reaction, using it will help them to feel better quickly. It is never too early to help your child become confident about the use of an auto-injector.
Talk to your child about the emergency steps, so that going to the hospital won’t be a surprise.
Help your child to feel more in control by practicing with a training device. Even preschool-aged children learn from medical play, just as they might by playing with a toy stethoscope before visiting their doctor. This can be a great way to make sure they understand about the auto-injector and how it will help them in an emergency.
Your child may think the needle in the auto-injector is as long as the device. If your child is worried about this, you can tell them it is much shorter. The typical length of an auto-injector needle is less than 1 inch or 2.5 centimetres.