When to give the epi , when to watch

Posted on: Mon, 09/11/2006 - 8:13am
maphiemom's picture
Joined: 12/01/2005 - 09:00

i am unsure of what to instruct our school regarding my daughters peanut allergy and when to give EPI, she ate a peanut at 2 ,I should have stopped that if only I could turn back time, anyway immediate reaction, jamming her fingers down her throat, scrapping her tongue, sweating and then hives and fatique, called 911 and after 7 minutes of frantic waiting they assessed her and stayed for a while took her blood pressure and determined that she was ok and did not need any treatment at all, since then she has tested twice positive to two skin tests two years apart, she recently had a transfer exposure to what we imagine is peanuts at a resturant from either her glass of napkin she got hives with white pimple type spots inside the hives, we watched her very closely and she again settled on her own , no further symptoms, so I never thought to give her Epi , we couldn't source benadryl because all stores were closed, anyway that is her past so far dealing with this allergy , so what do I tell her school is the right thing to do if they suspect an exposure or see hives, should I say hives benadryl, and any further symptoms EPI and 911?? I would just like your thoughts on this, I recently tried an expired EPI on a veggie to get the feel of the experience but I would hate for her to experience such trauma unnessecerily and therefore scare her from carrying the epi in fears of another needle.This is so hard .
Thank you for your thoughts in advance.

Posted on: Mon, 09/11/2006 - 11:18am
mharasym's picture
Joined: 04/20/2001 - 09:00

Our doctor says Epipen for any suspected allergic reaction. He doesn't say wait for x number of hives, or 2 of 3 symptoms or only if trouble breathing or anything else. If you think he's having a reaction - give him the Epi and call 911. Done. Don't use Benedryl, don't wait and see.
Now, that all being said, we've never been in a situation where we "thought" he was having a reaction. Since he was diagnosed (age 18 months) he has never had a single symptom of a reaction to peanuts - that despite having a 100+ CAP RAST result!
So, all I can say is, if we would see him react, we would Epi and 911 and those are the instructions on his plan at school.

Posted on: Mon, 09/11/2006 - 11:25am
3xy1PAinNH's picture
Joined: 08/07/2006 - 09:00

I think we have to be careful with this one, as there are many degrees of reaction to PA. I would, in your situation, NOT give epi first. Obviously, the other poster above me has a child with an extraordinarily high RAST. The ODDS of a severe reaction are basically 100% with that sort of number.
My son had a reaction at 18 months. Benadryl worked. The said to benadryl every 4-6 hours for the next five days (YES, WAKE HIM UP to dose him!).
THe allergist did the RAST and gave us an action plan (something I thought all schools legally had to have from a DR.). It says for mild symtoms like hives, benadryl. If there is wheezing or breathing difficulty, then Epi. It is veyr clear...if you see xyz, do this dose of benadryl, if you see abc, give Epi and call 911.
Hope this helps!

Posted on: Mon, 09/11/2006 - 12:39pm
mommamia8's picture
Joined: 11/13/2005 - 09:00

Hmmm. Our allergist feels hives are major. He wants us to epi for full body hives that occur soon after ingestion, with or without other symptoms. He feels internal problems could be occurring without us knowing right away.
Btw, my son's reaction to a bite of scrambled egg caused full body hives about 7 hours later...no one can explain this odd reaction to me yet. The allergist said we could give Benedryl if THIS situation happened again.

Posted on: Mon, 09/11/2006 - 2:49pm
joeybeth's picture
Joined: 09/01/2006 - 09:00

i had an incident happen just hours ago that put me in the position of having to decide what to do. we attended a PAl meeting (similar to PTA, maybe....a parents assistance league grou that helps out the teachers and our school...).
anyhow, it was their first meeting of the schoolyear and they served dominoes pizza, chips (safe ones), and cookies (not sure so we avoided them completely) and drinks.
my two PA daughters each took 2 slices of plain cheese pizza and a sealed bag of chips (doritos) and a coke. we were seated at tables that are used during the day as tables for the lunchroom.
within minutes of sitting down and eating a few bites of pizza, one of my daughters (the youngest) developed three hives on her face...very small, whitish ones as opposed to what our "usual" are....large, red hives.
she also developed a hive on her shoulder, neck, arm and a rash on her leg about the same time.
she complained of her eye itching after i pointed out the hives to her. before i mentioned the hives, she was completely unaware of any symptoms at all.
i couldn't decide what to do. if i gave the epi there would be a good chance it was premature and/or unnecessary.
sidenote...i had forgotten, for the first time i can remember, the benadryl!!!! i had changed bags just today because one of my girls had played at a friends across the street....
after just a few minutes had passed, the hives completely disappeared (almost as fast as they had appeared) and my daughter seemed fine.
was a bad mother for not giving epi immediately? maybe. was i scared to death that a reaction was going to rapidly progress right before my eyes? you bet. did i do the right thing? who knows.
incidentally, i don't know if it was cross contamination of some sort, a different allergen that caused the problem (she had mild allergies to egg, wheat, soy and a few others....but they've given us NO problems in recent years). it looked very similar to the aerosol and skin contact reactions she's had in the past. i noticed that the table surface was not really very clean and the cracks where the tables are meant to fold in the center were caked with food from past lunches at that table. GROSS!!! so...my guess it was a contact reaction of some sort from the table; but i will never really know.
it was one of those situations where you just hate like *^@% to "wait and see" but it seemed like the only thing i could do at the time. would i want a school employee/teacher waiting like i did? not sure. it was such a bad spot to be in.
this probably required it's own thread...and maybe i'll do that. it just seemed oddly applicable to this topic. what a coincidence!

Posted on: Tue, 09/12/2006 - 1:21am
bethc's picture
Joined: 04/18/2005 - 09:00

It is extremely helpful to get a Food Allergy Action Plan from an allergist. They can go down and check the action required for each symptom based on your child's reaction history. For us, it's any symptoms from peanut ingestion require the Epi and Benadryl, then ER. Ingestion without symptoms (if that should EVER happen) requires only Benadryl. But the trouble comes when you don't believe they've eaten anything with a trace of peanuts in it but they get a hive or 2. I've asked our allergist about this situation, and he said it would be fine to just wash the spot, maybe give her Benadryl, and keep an eye on her for any further symptoms. People do get mystery hives, and my DD is one of them. Now, more than 2 spots, I'd go for allergic reaction, I think, even if I can't come up with a reason. But that's just me knowing how things have gone in the past.

Posted on: Tue, 09/12/2006 - 1:33am
saknjmom's picture
Joined: 04/02/2003 - 09:00

I feel that you should discuss this with your doctor and you should think about how your child "typically" reacts.
My son has always been a "hivey" kid. He has a lot of environmental allergies which cause hives. He had one ana reaction (first time allergy was diagnosed) and his symptoms were pretty clear sudden tiredness, difficulty breathing, hives, coughing, etc.
So, for him I prefer benadryl be given first, that he be watched closely until the hives are gone. If he shows any other signs of ana. shock epi pen.
Seems that there are so many different circumstances and ways people react that it is impossible to say which way is right.

Posted on: Tue, 09/12/2006 - 2:35am
maphiemom's picture
Joined: 12/01/2005 - 09:00

I did have her allergist suggest that if there were any symptoms of breathing trouble to administer EPI, I instructed the school in case of just hives , give benadryl and I will come get her , and then it was at their discretion to determine weither Epi is needed if any other symptoms appear.They of course can give it at first signs if they so choose, and accompany her by ambulance to hospital in such a situation, we managed last year to not have any problems, lets hope this year is the same, the school is much more proactive than last year which is a move in the right direction.Thank you for your thoughts.

Posted on: Tue, 09/12/2006 - 2:45am
anonymous's picture
Joined: 05/28/2009 - 16:42

Our allergist says each person is different, and you need a plan that YOU AND YOUR CHILD feel comfortable with. My son is at the age now when he KNOWS exactly when he needs epi verses benedryl and wait.
Talk with your doctor, don't take other people's situations as your own.
mom to Ari(6) - severe nut allergies, asthma, you name it - and Maya (9), mild excema

Posted on: Tue, 09/12/2006 - 3:30am
Sharonagain's picture
Joined: 08/13/2006 - 09:00

My son (14 months) is allergic to peanuts. We don't know HOW allergic. He ate peanut butter 3 times and each time he had a rash/hives around his mouth. These hives didn't bother him and they went away within 45 minutes. We went to 2 allergists and they said he was PA and prescribed Epis. I wanted to know regarding Benadryl...I've read that you SHOULDN'T give Benadryl because the medicine could mask the symptoms and you wouldn't know how severe the reaction is? Any suggestions?

Posted on: Tue, 09/12/2006 - 3:38am
k9ruby's picture
Joined: 03/25/2004 - 09:00

My home plan is:
Any known ingestion- watch
Injestion and any reaction (apart from one situation we had in the past i ate traces of hazlenut in milky way. mums a medical proffessional! without us knowning (thought it was fine cus it was before) hives on leg. cream and antihistimine, gone, very lucky, others,epi +999.
Contact/other- hives, mild non facial swelling, redness, mild gi symptoms, ANTIHISTIMINES
Anything else, EPI
We have said to school, If hives, contact parents and watch. anything else, epi 999 ,parents.


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