Is Benadryl in your allergy action plan?

Posted on: Tue, 03/13/2007 - 1:45pm
Laifong's picture
Joined: 07/12/2004 - 09:00

I am in the process of writing an allergy action plan for my son for kindergarten. His allergist is very much against using antihistamines, saying that it may cause a delay in using epinephrine, or mask some symptoms of anaphylaxis. I agree with him, but I am wondering what to do then in the case of localized hives (i.e. from contacting the allergen). Just wash with soap and water? It's also hard to try and cover every possibility because my son's reaction history has only been 'mystery' hives.
I am also trying to figure out how to include the asthma plan. My son has mild intermittent asthma and uses Flovent and Albuterol only when he has a cold. He has never had exercise-induced asthma attacks. I am concerned that symptoms of a food allergic reaction may be mistaken for an asthma attack. I would like to hear how you all approach similar issues in your action plan.

Posted on: Wed, 03/14/2007 - 12:07am
chanda4's picture
Joined: 12/14/2006 - 09:00

I am currently working on my 504 too and this is somethign I am struggling with wording. I am more worried they'll try giving him his inhaler during an attack, I have done it myself. All turned out fine, but I don't want them focussing on the asthma so much....especially when there are other symptoms. He also was flushed, grabbing his neck and very scared...reactions from pistachio...I'm his mom, I should have known better.
I do have Benedryl in the 504 though, I do want them giving it first, I always do, unless he is clearly coughing, choking, or his neck squeezing....if he has hives, I don't want them stickign him with the epipen everytime. One mom here mentioned her son becomming a pin cushion....which I agree. He has had approx 15+ reactions and I've always given Benadryl....looking back, abotu 5-6 of those I should have doen the Epipen...but at the same time, he was fine. I think it is a fine line and needs to be explained in detail. I printed that Food Allergy Action Plan from FAAN and it has symptoms-medications, which I like because I can detail *how* to treat *what*. There are only 2 areas of a reaction I said to start with Benadryl and that is mouth(itching, tingling) and skin(hives, itchy rash)....the rest needs to be givien Epipen(Mouth if it consists of any swelling and Skin is there is any swelling to the face)...then Gut, Throat, Lung, Heart and Other are all Epipen.
I'm sure we'll get more advice here soon, the ladies here are SO helpful!! I'll also see what they say, I want to be very sure, like you!! Thanks [img][/img]
Chanda(mother of 4)
Sidney-8 (beef and chocolate, grasses, molds, weeds, guinea pig & asthma)
Jake-6 (peanut, all tree nuts, eggs, trees, grasses, weeds, molds, cats, dogs, guinea pig & eczema & asthma)
Carson-3 1/2 (milk, soy, egg, beef and pork, cats, dog, guinea pig and EE)
Savannah-1 (milk and egg)

Posted on: Wed, 03/14/2007 - 12:42am
Anonymous's picture
Anonymous (not verified)

My son has an allergy to insect venom. Contact is not a concern. His plan is if localized swelling give benedryl.
He has not had an anaphylactic reaction, and he gets stung/bit almost daily in warm weather. I really don't want him epi'd that often, when he's not having a serious reaction. [img][/img]

Posted on: Wed, 03/14/2007 - 12:52am
bethc's picture
Joined: 04/18/2005 - 09:00

I gave the school a copy of the Food Allergy Action Plan we got from DD's Dr. For her, if we believe she's ingested peanuts but has no symptoms (can't really imagine it, but this is what the Dr. said), the plan says give Benadryl only. If she has any symptoms after an ingestion, she has to have the Epi and Benadryl. She's had serious reactions in the past, so that's why hers calls for that.
The FAAP doesn't address contact reactions and mystery hives, so we discussed that and put our ideas into the school's emergency plan. Basically, the mystery hives should be washed with soap and water and it's OK if the nurse puts hydrocortisone cream on them. The Dr. said wash, and if they don't go away after a bit, give Benadryl. The nurse always calls me when DD ends up in the office with a few hivey spots that pop up for no apparent reason, so we actually have a chance to discuss what to do after washing. They wouldn't wait to contact me in an emergency, but she gets a couple of mystery hives or a little rash quite often, so we don't treat that like an emergency.
My DD was diagnosed with asthma at the end of last school year, and we were concerned that a food allergy reaction could be mistaken for an asthma attack. So we did discuss that with the nurse and teacher at the start of this school year. It helps in our case that DD's asthma is well-controlled and hardly ever causes symptoms anymore, and that before it was treated, it was pretty much just a cough that she never got over. So the nurse knows that if she's struggling to breathe, it's probably a peanut reaction and not an asthma attack.

Posted on: Wed, 03/14/2007 - 3:38am
anonymous's picture
Joined: 05/28/2009 - 16:42

for hives yes, anything more, and any breathing difficulties we have them go straight to the epi and 911.
My son occasionally gets unexplained hives, or mild hive reactions to some of the things he is not as sensitive to, like peaches. Also he has pollen allergies which cause his eye to get very puffy. In those cases we do a benedryl and wait approach.
Some people prefer to go right to epi, YMMV.
mom to Ari(6) - severe nut allergies, asthma, you name it - and Maya (9), mild excema

Posted on: Mon, 03/19/2007 - 11:53am
Laifong's picture
Joined: 07/12/2004 - 09:00

Thank you everyone for your replies. They are helping me to think through how I want to write up the action plan.

Posted on: Mon, 03/19/2007 - 9:58pm
saknjmom's picture
Joined: 04/02/2003 - 09:00

for minor hives, how about wash with soap and water and apply topical cortisone or benadryl cream?

Posted on: Thu, 03/22/2007 - 1:41pm
3xy1PAinNH's picture
Joined: 08/07/2006 - 09:00

Quote:Originally posted by saknjmom:
[b] and apply topical cortisone or benadryl cream? [/b]
Just be careful about giving a child a topical benadryl, b/c then you can not (should not ) give oral benadryl. My pharmacist told me years ago there is a reaction (not common) taht can occur if you are given both types of benadryl. Just as an FYI.

Posted on: Thu, 03/22/2007 - 11:07pm
saknjmom's picture
Joined: 04/02/2003 - 09:00

Quote:Originally posted by 3xy1PAinNH:
[b] Just be careful about giving a child a topical benadryl, b/c then you can not (should not ) give oral benadryl. My pharmacist told me years ago there is a reaction (not common) taht can occur if you are given both types of benadryl. Just as an FYI.
This is interesting and I will ask about it next time we're in the dr office. I had a situation with the school policies about benadryl and epi pens. I was not allowed to have a backup because my dr. ordered benadryl if there are hives followed by epi pen if symptoms persist.
Since laypeople are allowed to give the epi pen, but not benadryl the order could not be followed, so I wasn't allowed to have a trained backup for epi pen if the nurse was absent.
We discussed removing the benadryl order, but my son used to have a lot of mystery hives and I didn't want him getting the epi pen every time he was itchy...
In the end, I left cortisone cream, but left the benadryl order and they call if there isn't a nurse in the building and DS stays home.

Posted on: Thu, 03/22/2007 - 11:43pm
momll70's picture
Joined: 09/26/2006 - 09:00

When my son gets mystery hives (most people won't notice them because they are usually light) I'm the one who notices. I just wipe him down and wipe where the hives are in case there is still the allergen on his skin. I watch him.
The only time I give benadryl is when I know he is reacting to something else other than the stuff he is allergic to like when he had a hive from antibiotics. I knew that was the only new thing and he complained about throat itching 1 hour after giving it to him and next morning 1 hive on arm. I gave him Benadryl.
I almost gave him benadryl when people kissed him after eating cookies I didn't know had nuts in them and 1/2 of his face turned really bright red. No hives just flat red color. I didn't in case it would turn into an internal reaction. I wiped him away from the mouth and eyes and it went away after 30 min.s I was really scared and wonder if I did the right thing.
Our plan requires just epi-pen. If he got more mystery hives in school and they had to inject him all the time then I would allow benadryl as I wouldn't want him to be injected for just a couple of mystery hives that clear on their own whithin 1/2 hour. Usually his do and so far have not progressed into full body hives.
When he does get full body hives it happens immediately so I can tell the difference now between and ingestion and contact. I always keep an eye on him because reactions can change. His internal reactions were to traces must have been on his hands after touching a couch or table. If he actually eats more than a trace his reaction may be different (vomiting then hives) I don't know, then I would give epi.
I carry Benadryl but the school only has 2 Epi-pen, Jr.'s. It's so confusing especially when you are dealing with more than 1 allergy.
[This message has been edited by momll70 (edited March 23, 2007).]

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