How to manage allergy emergencies in children

Little girl blowing her nose.

Cropped image. Oddharmonic, Flickr. CC License.

What are allergies?

  • They are abnormal immune system reactions to things that are non-threatening to most people. When a person is or becomes allergic to a particular substance, the body thinks that the substance is trying to harm the body. That’s when the immune system mounts its response and we see the physical symptoms. The symptoms can range from just annoying to life-threatening.
  • Substances that can cause potential allergic reactions are foods, dust, pollen, medications, bugs and topical preparations.

What are the signs and symptoms of allergies and allergic reactions?

  • There is a wide range of allergy symptoms that can vary in different people.
  • The life-threatening version is called anaphylaxis.
    • This can cause potentially life-threatening symptoms in seconds. It is critical to determine if the allergy is causing this type of reaction very quickly.
    • People with anaphylaxis risk must carry an EpiPen® (or other brand of epinephrine auto-injector) with them at all times. It is a good idea to have an antihistamine around as well.
  • Seasonal allergies more commonly cause sneezing, itchy nose and/or throat, stuffy nose, coughing, and/or watery, itchy eyes.
  • Insect, medications, food cause more widespread symptoms such as coughing, vomiting, diarrhea, abdomen pain, swelling, trouble breathing, wheezing, in addition to the common ones listed above.

Who diagnoses allergies?

  • The pediatrician, family doctor, allergy specialist, or stomach specialist are all able to diagnose allergies. It is best to start with your primary provider first.

Prevention is the key to reactions.

However, being prepared is the medicine to treat the reactions.

What to do when there is a reaction?

  • Stay calm.
  • If there is ever a question, call 911.
  • Call your doctor if it is your first reaction, or one that is more than you expect.
  • If the symptoms are mild, you can give an antihistamine. Call your doctor if the dose isn’t on the bottle for your child’s weight.
  • Wash the affected area if it is a topical exposure.
  • If the symptoms are severe or progressing fast, use an EpiPen if you have one. Call 911 as well. It is always better to be safe than sorry.

Other pointers about severe allergic reactions.

  • Consider an allergy band for the child to wear at all times.
  • Be sure to have an updated allergy/anaphylaxis plan filed at your child’s school.
  • If your child has an EpiPen, make sure that everyone in the family is used to using it. Ask your provider to write a prescription for a trainer pen and practice with it as a family once a month.
  • Keep extra EpiPens and antihistamine wherever you might need them. Up north at the cabin, on vacations, in sports bags, in purses, overnight bags, etc. It is a good idea to write a date with the current dosage and weight on each bottle so there is no need to calculate when it is needed.
  • Become informed and educated by reading labels and telling anyone who might need to know about your child’s allergies. Making sure all the siblings know them as well.
  • Find a support group. Talk to your pediatrician or family doctor. You are not alone in the worry that comes with life-threatening allergies.

– Sarah Rauner, CPNP Chief Pediatric Nurse Practitioner, Pediatric Emergency Center at Beaumont, Troy

2 Responses to “How to manage allergy emergencies in children”


  1. 1 pook2esq May 2, 2018 at 12:50 am

    Thank you for this – is there a way to get an EpiPen if your child has not had an allergic reaction yet? As new moms introduce new foods its terrifying to think of having to face a reaction that is unexpected without one.


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