What to Do in a Food Allergy Emergency

Food Allergies 101

Food allergies happen in 6 to 8 percent of children ages four and younger, and in about 4 percent of adults, experts estimate. Reactions vary from mild rashes to difficulty breathing, and account for 30,000 emergency room visits a year, while tens of thousands of other reactions are treated at home. These allergies also cause approximately 150 deaths each year from food-induced anaphylaxis, a sudden, severe, potentially fatal reaction.

More than 160 different foods have been linked to allergies, with eight of them causing 90 percent of these severe reactions. The troublesome eight are peanuts, tree nuts, fish and shellfish (these allergies often persist into adulthood), and eggs, milk, wheat and soy (children generally outgrow these as their immune and gastrointestinal systems mature). “Part of the problem with these foods is that they are very common ingredients,” says Jonathan Bernstein, MD, a professor in the Division of Immunology and Allergy at the University of Cincinnati College of Medicine.

What to Do in an Emergency

Anaphylaxis is a sudden, severe and potentially fatal allergic reaction that can involve the skin, respiratory tract, gastrointestinal tract and cardiovascular system. The only sure treatment is strict avoidance of known allergens. In case of accidental exposure, be prepared:

• Always carry at least two doses of self-injectable epinephrine to allow time to get to a hospital. A shot of epinephrine reverses the life-threatening symptoms but may only last 10-20 minutes. “Don’t think twice about taking epinephrine,” says David Fleischer, MD, an allergist in Denver. It’s generally not going to hurt, and it’s probably safer not to wait.
• Carry an antihistamine like Benadryl, too, either in liquid or quick-dissolving tablet form, to treat milder reactions. While an antihistamine may help, it isn’t a substitute for epinephrine.
• Wear a medical alert bracelet or other identification jewelry.
• Even if the symptoms go away, call 911 or go directly to an ER, but don’t drive yourself.

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