Allercy and Asthma Health
The Official Publication of AAN - MA

Careful What You Eat—
Would You Know Anaphylaxis If You Saw It?

by Eileen Censullo, MBA, RRT


Anaphylaxis is a rapid onset, potentially life-threatening, whole-body allergic reaction that can happen to any person, any time, for a variety of reasons. But it is most commonly associated with certain risk factors, such as bee stings and food allergies with foods like peanuts or fish. With anaphylaxis, the person may experience serious respiratory compromise—where they stop breathing—or cardiovascular shock.

Deaths can occur with anaphylaxis. This most commonly happens when people are away from home and treatment is delayed. There are three major risk factors for fatal anaphylaxis:

  • Allergic reaction to food, stinging insects, or medications
  • Presence of asthma
  • Delay in administration of epinephrine

A patient who has been diagnosed with an allergy that can cause anaphylaxis should always carry, or have immediate access to, an injectable epinephrine pen, or “epi pen.” This is a small tube with an auto-injectable carriage to inject the proper dosage for the patient. In the case of a child, each person or caregiver who comes in contact with the child should be made aware of the risk and know the action plan for that child. This plan should ask and answer the following questions:

  • What are you allergic to?
    • Food: nuts, wheat, chocolate, etc.
  • What are the symptoms of anaphylaxis?
    • Wheezing
    • Chest pain
    • Shortness of breath
    • Apnea (not breathing)
    • Sweating
    • Increased heart rate
    • Fainting
  • What is the action plan?
    • Call 911
    • Make sure the person is out of harm’s way
    • Administer epi-pen
    • Deliver bronchodilator (if ordered)
    • Call caregiver (if not in attendance)

Anyone who is responsible for children needs to know about their health issues. This includes extended family, coaches, teachers, volunteers, nurses, child care providers, or trainers.

Knowing what to do in the event of an anaphylaxis event can save lives. Ensuring that each patient has an action plan is the key element. Utilizing this action plan is crucial to success.

Parents should take the time to review their child’s illnesses (if any) with anyone who may be with the child for an extended period of time when the parents are away. Ensuring that the caregiver has the necessary tools in the event of anaphylaxis could possibly save the child’s life.

Parents should educate everyone in the child’s classroom as well—teachers, students, and parents. Other parents may not be knowledgeable about the risks and consequences of anaphylaxis. Unless this is something you have experienced for yourself, or it has happened to someone you know, you may not realize how critical it is to keep the allergen away from the patient. Keys to success include:

  • Prevention
    • Education
    • Knowledge (avoid allergen at all costs)
    • Action plan
    • Carry an epinephrine auto-injectable pen at ALL times
  • Treatment
    • Call 911
    • Action plan follow-through
    • Establish safety
    • Deliver epi pen
    • Deliver bronchodilator if ordered
    • Contact caregiver

Allergies to foods and other substances are common. Never be embarrassed to speak up and say you have an allergy to something. It may just save your life.

Eileen Censullo is a member of the American Association for Respiratory Care from Phoenixville, PA, where she serves as a clinical data manager for DSG, Inc. Censullo is president-elect of the Pennsylvania Society for Respiratory Care.
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