When people discover I work as an emergency room pediatrician, they often ask what disease or condition brings the most children to the ER. When I tell them, they are usually shocked. Besides the common medical emergencies most kids face — high fever, flu, upper respiratory issues, concussions, falls, cuts and sprains — here in central New Jersey, we are seeing an increased frequency of severe allergic reactions.
Often, parents and caregivers don’t react to these symptoms quickly enough and realize the child could quickly become gravely ill. Here’s a recent example: Two new parents gave their baby fish for the first time and she quickly developed a severe rash followed by difficulty breathing. Rather than call an ambulance for immediate assistance, which is recommended, the couple drove the child to the ER.
When the baby arrived, we immediately administered epinephrine, a vital treatment for anaphylaxis (a severe allergic reaction that could be life-threatening). Within minutes, the child’s condition markedly improved. After we observed her for several hours to ensure there would be no secondary attack, the baby was cleared to go home. Thankfully, this case had a happy ending. Pediatric allergic reactions often catch caregivers off guard and it can be tough to gauge the severity of the situation. But it’s important to act quickly because you simply can’t determine how far the reaction will progress. Delays in getting medical attention to the allergic reaction can lead to severe complications. The hard truth is that, in rare cases, allergic reactions can be fatal.
The most common allergens: food, insect bites and drug reactions
Nearly 6 million American children have diagnosed food allergies and almost 40 percent of them have a history of severe reactions. Most food reactions are caused by just eight foods: milk, soy, eggs, wheat, peanuts, tree nuts, fish and shellfish.
When you are stung by an insect, poisons and other toxins enter your skin.An allergic reaction occurs when your immune system reacts strongly to the allergens in the sting. It’s normal to have swelling and itching around the sting, but some children can have severe reactions.
About 20 percent of the population has some kind of medication allergies, with the antibiotic penicillin at the top of this list. Symptoms can occur fairly quickly or they can begin days after taking the drug. Anaphylaxis usually occurs immediately after taking the drug.
If symptoms from any reaction include difficulty breathing, inability to swallow, significant facial swelling or mental confusion, call 911 for assistance.
Signs of life-threatening allergy (anaphylaxis)
The signs and symptoms of anaphylaxis can vary. They usually present quickly but can take up to an hour to fully affect the child.
Here’s what to look for:
coughing or difficulty breathing
wheezing, itchy throat, difficulty swallowing
itchiness, red bumps or hives
nausea, vomiting, abdominal pain, diarrhea
dizziness, chest discomfort or tightness, mental confusion
As soon as anaphylaxis is detected, administer epinephrine (EpiPen or the newer brand Auvi-Q) if you have it. This injectable medication will help to overcome the immune system’s response to the allergy trigger.
As with all pediatric emergencies, be safe by immediately reaching out for professional medical care any time your child has symptoms that affect their ability to breathe and swallow. Our local EMTs are ready around the clock to help you.
CentraState Medical Center’s Pediatric Emergency Care Department offers a warm and family-friendly environment supported by a team of board-certified pediatricians, nurses and clinicians on site at all times.The department provides a special treatment area reserved exclusively for children. For more information, visit centrastate.com or call (866) CENTRA7.
Dr. Mehta is a board-certified pediatrician and serves as division chief of the Pediatric Emergency Department at CentraState Medical Center. He can be reached by calling 732-294-2666.