When should I give epinephrine? My 2 year old daughter had a reaction to a cookie and her symptoms were swollen bottom lip, some mild coughing and then she threw up. I gave benadryl, but held off on the epi. Should I have given it to her?

This is a question that should only be asked and answered by your allergist. It really depends upon your daughter and her allergies.

I think a safe rule would be when in doubt-give the epi pen.

That being said many allergists believe that if the reaction affects one system only like hives only, runny nose or eyes only, itchy tongue only-then you probably will/do not need the epi pen.

However more than one system like hives and itchy tongue, or the symptoms you listed above would/should require the epi pen.

It's a tough judgment call for us all and we've all been where you are before. But again, you should ask your allergist and when in doubt give the epi pen.

Should you choose to use Benadryl in the future do keep in mind that it is not a life saving medication and that it may only delay more severe symptoms. The allergic reaction could come back after the benadryl wears off-which could be frightening if that happens to be when your child would be sleeping.

Hope that helps and hope your daughter is feeling better!
Ruth

If it was my child having the same symptoms, I would certainly give the Epi-Pen injection. Benadryl will take too long to work (even in the liquid form). Also, benadryl, being an anti-histamine, will block the release of histamines (one of many mediators of a reaction), but will not take care of IgE. If you ever have to give a benadryl for a reaction and it's later in the evening, the advice is to call your pediatrician and see if a steroid (ie. prednisolone liquid) should also be started before putting the child to sleep. Prednisolone will calm down the immune reaction (IgE). If in doubt, give the EPI.

This is a tricky call. Our allergist has said, "If you're questioning whether or not to use the Epi, you probably should use it." That's easier said than done when you're in the situation.

I hope your daughter is feeling fine now.

My allergist told me that nausea is one of the first signs of shock and an epipen should be used if I feel sick, especially if i start coughing.

I agree you should trust you dr. on that one. I have a pa daughter and have been told by a close fried that has used an epi pen on herself and has experienced it first hand that if I can avoid using it, my child is better off. I was told to try and ensure follow up medical care is readily available if the child has never had the epi-pen before. I was told in and of itself it is a frightening experience. It sounds like the benadryl did the job. I also think it depends on the childs reaction history. When in doubt call 911, it should only take a few minutes for arrival and they will be able to talk to you and tell you if its time or at least give a second opinion on the severity.

My daughter had very similar reactions when she ingested peanut. We didn't bother with benadryl and immediately gave an Epi-Pen injection and rushed to the E.R. They said we did the right thing, I guess vomiting is usually a bad thing. I still think you should discuss this with your allergist.