The patient should have an Emergency Plan that outlines what medications to take and what to do. If exposure to a food occurs, time is of essence. Trying to clear the food out of the mouth is important. Inducing vomiting is not always recommended. Calling 911 (emergency medical services) may be necessary.
The Emergency Plan for Food Allergy Reaction:
- Take an antihistamine such as Benadryl ®
- A dose of prednisone is generally recommended
- If there is trouble breathing, fainting, swelling of the lips, tongue or throat, or loss of blood pressure, this will require an injection of Epinephrine. A second injection of epinephrine may be needed within 20 minutes
- Use albuterol to bronchodilate if the person has asthma
- Call 911 (emergency medical services) as soon as possible. Trying to drive to the emergency department may take too long
Some reactions will only consist of hives or extreme itching, and these sometimes can be stopped by the use of an antihistamine and prednisone. Each reaction will be different and can be life threatening, so take all exposures to the dangerous food seriously. Epinephrine is very helpful to stop a reaction, but works best when given early in a reaction.
About Epinephrine (Epipen) Injectors
Two brands of epinephrine auto-injectors (self-firing) are the Auvi-Q®, Auvi-Q Jr. and the Epipen®, and Epipen Jr.®. Practice with the expired Epipens®.
To learn how to use these, we recommend first firing them into a cardboard box, and observe how the needle comes out and how the epinephrine squirts out. Demonstrate and teach anyone who cares for a family member with a food allergy; teachers, nurses, neighbors, grandparents, etc.
Adrenaclick is an epinephrine auto injector that you may be able to locate, (they are hard to find), that is less expensive than theEpipen® and Epipen Jr.®
A Note About Epipen Pricing
We have been asked about the idea of a generic Epipen® and Epipen Jr.®. My response is that the generic price is ridiculously high as well, and continues the price abuse that Epipen® and Epipen Jr.® have been charging. The manufacturers of epinephrine auto injectors have been able to keep other auto injectors out of the marketplace for quite sometime, this has allowed them to stop competition and raise their prices.
We have been well aware of the price abuse concerning Epipen® and Epipen Jr.® for many years. For that reason we have been providing ampuls of epinephrine to our patients at a nominal price ($6 per ampul), to help assure that they have epinephrine available at al times. These ampuls contain epinephrine, the same as the epipen, but must be drawn up into a small syringe and then injected into the same area that you would apply an epipen. This actually is how epinephrine is used in hospitals and clinics.
Ask your provider if they would provide you with this form of epinephrine, we use epinephrine injection ampul 1:1,000 uni-amp manufactured by hospira. adults apply .3 ml, children .15 ml.
Emergency Health Care Plan
Our Emergency Health Care Plan is often given to patients who have a moderate to severe food allergy and carry an epi-pen. This document identifies signs of an allergic reaction and provides a plan to follow in case of an allergic reaction. If the patient suspects that he or she has ingested a food they are allergic to, (or develops hives, itching, flushing) they are to take Prednisone and Benadryl. Doses vary according to the age and weight of the patient and may range anywhere from 3/4 tsp – 1 1/2 tsp for a young child and 20mg or 4 (5mg) tablets for an older child. For more severe symptoms, one should not hesitate to administer a dose of epinephrine. The patient may repeat another dose of epinephrine in 10 minutes if symptoms persist.
Download a copy of our Emergency Health Care Plan.
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