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

Summer Sniffles?

 Young girl picking flowers in a field

The scent of freshly mowed lawns, blooming flowers and blossoming trees signal that spring and summer are here, but for allergy sufferers this likely means more than just the arrival of a new season. For allergy sufferers and their parents, these scents can signal the start of allergy season.

So what causes those pesky allergies?

Allergies occur due to an immune response. Once someone with the potential for allergies is exposed to a specific allergen, the body will prime itself to recognize that allergen and upon further exposure will stimulate an allergic cascade ultimately leading to inflammation. The receptors that allergens will bind to can be found in the skin, nose, mucous membranes and lungs, which is why the predominant symptoms of allergies are in these regions.

Symptoms of allergies

Allergy symptoms occur due to inflammation. On the skin, a rash like eczema or hives is often the predominant finding. When the nose and mucus membranes are affected, nasal itching, sneezing, congestion and clear drainage from the nose is common. Some people also have ocular symptoms with itchy, clear drainage and swelling around the eyes. For those with asthma, allergens are often a trigger of their symptoms; cough and shortness of breath may occur after allergen exposure. Despite the organ systems affected, allergies don’t cause fever so if your child has a fever it’s likely something else.

Who is affected and why?

The potential to develop allergies is genetic. If one parent of a child has allergies their child has a 1/3 chance of developing allergies. If both parents have allergies, their child has a 2/3 chance of developing allergies. While the allergic potential is passed on, the individual allergies aren’t. For example, having a parent with a shellfish allergy doesn’t mean that same allergy will be passed on, but the child has a chance of developing allergies such as atopic dermatitis, food allergy, asthma or allergic rhinitis.


If you find yourself reaching for a tissue every time you walk past a freshly cut lawn, it can be pretty easy to determine the trigger for your symptoms. But for those who have symptoms all year or all season long, allergy testing may be helpful in determining triggers.

Allergy testing can be accomplished by a blood test or by a skin prick test in which small amounts of allergen are scratched onto the skin and after waiting approximately 15 minutes, an allergic response is measured on the skin by a surrounding hive and redness.

What can you do?

Allergy treatment is often effective at improving quality of life. Allergy treatment is typically managed with a three-step approach.

  1. The first step is avoidance. This is much easier to do with a specific food or medication allergy, but nearly impossible with a seasonal allergen.
  2. The second step is reducing the inflammatory mediators caused by the allergic response. This can be accomplished through medications such as antihistamines and nasal steroids. For those with skin problems, using a non-scented soap and applying a good moisturizer like Cerave twice daily and immediately after a bath with Vaseline or Aquaphor to dry spots can be very helpful. While many medications are available over-the-counter, it’s always best to check with your child’s pediatrician or allergist before starting a new medication to make sure the medication and dosing are safe and appropriate for your child.
  3. Third, allergen injections can be tailored to a person’s specific allergies and given regularly over a three- to five-year period to desensitize a person to the specific allergens triggering their symptoms.

If you think that you or child’s symptoms might be due to allergies, it’s always best to check in with your physician. Hopefully with treatment, the scents of a new season can mean more time spent outside and less time reaching for a tissue.

– Melissa Rettmann, M.S., PA-C, has a background in pediatrics and allergy. She is the mother of a toddler and volunteers with the Parenting Program.

Kids Have Allergies? Get a Pet.

A new study in the Journal of Pediatrics explains why kids with allergies may actually do better when they get a pet. Beaumont Pediatric Allergist Dr. Marty Hurwitz states that having a dog can reduce the incidents of respiratory infections during an infant’s first year of life. He advises challenging the immune system by having a dog or cat that also spends time outdoors.

Hear what Dr. Hurwitz and Dr. Frank McGeorge of WDIV-TV4 have to say here.