Anaphylaxis - What Is It?

Before Sunday, I was under the impression that anaphylaxis was the inability to breathe. If you had asked me on Sunday whether Cole was having an anaphylactic reaction to bananas, I would have said no because he did not exhibit any signs of difficulty breathing. He did not cough, wheeze, hiccup - nothing. Also, his tongue and lips did not swell. This is the number one reason I did not drop everything and take him to the hospital immediately.

I was wrong, wrong, wrong. Here is the official definition of anaphylaxis from the Food Allergy & Anaphylaxis Network:

An anaphylactic reaction may begin with a tingling sensation, itching, or a metallic taste in the mouth. Other symptoms can include hives, a sensation of warmth, wheezing or other difficulty breathing, coughing, swelling of the mouth and throat area, vomiting, diarrhea, craming, a drop in blood pressure, and loss of consciousness. These symptoms may begin within several minutes to two hours after exposure to the allergen, but life threatening reactions may get worse over a period of several hours.

In some reactions, the symptoms go away, only to return one to three hours later. This is called a “biphasic reaction.” Often these second-phase symptoms occur in the respiratory tract and may be more severe than the first-phase symptoms. Studies suggest that biphasic reactions occur in about 20% of anaphylactic reactions.

In Cole's case, he experienced hives, a sensation of warmth (his skin was hot to the touch), vomiting, a drop in blood pressure, and a near loss of consciousness. His initial reaction just included the hives and the sensation of warmth; his second-phase symptoms included the vomiting, drop in blood pressure, and near loss of consciousness.

Never during Cole's case, did I consider administering his EpiPen. Again, this was because I was under the impression that the EpiPen was only for use on children who were not breathing or who were having difficulty breathing. I did not know you could administer the shot to a child that had an open airway.

Again - I was wrong.

According to the EpiPen Web site:

If your child shows signs or symptoms of an allergic emergency, inject the EpiPen Jr. immediately, then promptly call 911 and seek immediate medical attention. Signs of an allergic emergency may include:

- Closing of breathing airways
- Wheezing
- Sneezing
- Hoarseness
- Hives
- Itching
- Swelling of the lips or tongue
- Numbness or tingling of the lips or tongue
- Skin redness
- Fast heartbeat
- Weak pulse
- Feeling anxious
- Confusion
- Stomach pain
- Incontinence
- Faintness or unconsciousness

Also according to the Web site: Don't be afraid to use the EpiPen during an allergic emergency. Using it at the start of such an emergency may prevent the reaction from becoming worse. There are no absolute contraindications to using an EpiPen in a life-threatening severe allergic reaction.

I am so thankful that I took Cole to the ER on Sunday. Things could have ended much worse, and I'm lucky that I've had this experience to learn what I should be doing. So - this is my PSA. For those you who are new to allergies, I hope this post can help you if you find yourself in an allergic emergency situation.