I am so sad whenever I hear about a child dying of anaphylaxis after eating something they were allergic to. But I'm very curious. Every time I read an article about someone who died, even after they were given an epinephrine injection, there is no mention of Benadryl or any other antihistamine. A lot of allergy bloggers and columnists have also written about their experiences of administering an epi-pen to their child. Still no mention of giving an antihistamine to the child before the epi-pen.
I always carry Benadryl, an epi-pen, and an albuterol inhaler for my two allergy kids. They have both suffered from anaphylaxis on several occasions, but I have always been able to slow or reverse the effects within a couple minutes by giving them Benadryl. A few of these instances were under the care of an ER doctor. They have never required an epi-pen injection.
I can only hope that the news articles don't mention antihistamines because they don't feel the information is pertinent enough to include in the article. I myself have suffered from anaphylaxis many times in my life. The last time I had to be rushed to the hospital in an ambulance. I had taken Benadryl as soon as I realized that I was suffering from anaphylaxis, but the symptoms came on so quickly that I thought I was going to die. I could barely breathe, my whole body was covered in hives, I couldn't hear because my ears were so swollen, and I had tunnel vision. And neither the paramedics nor ER doctor felt that I needed an epi-pen since I had already taken the Benadryl and they could see that my symptoms were subsiding. They observed me for a few more hours and kept me on a steady stream of more Benadryl.
My question to you mommas of kids with allergies: What is your first line of defense when your child is exposed to a life-threatening allergen? Do you carry Benadryl with you in addition to an epi-pen? Have you ever had to administer an epi-pen? Whenever I read about these moms who administer the epi-pen to their child, I wonder if they are aware that an epi-pen is not an antihistamine, but is there to just buy time until they can get further treatment for their child. I can only hope that my own children never suffer from such an extreme case of anaphylaxis like the kids who have died. It's crazy to think that ordinary food can be so deadly.
Thanks for all of your responses! It sounds like we're all pretty much on the same page with allergy and anaphylaxis treatments. I still can't wrap my head around that teen who died despite all of the antihistamines and epinephrine injections. It makes me wonder if I should try immunotherapy for my kids....
I carry one of the single serving spoons of Benadryl at all times for my peanut allergic daughter. I also carry an Epi-pen. Haven't had to use either, but the pediatrician recommended the Benadryl first, then if she's continuing to get worse, the Epi-pen.
Yes, I have had to administer the EpiPen to my son last year. He was 7 and ingested a tree nut. He was rushed by ambulance to the pediatric ER where he spent the next several hours for treatment and observation. I've also been to the ER on two occasions as a child after bee stings.
I always carry the EpiPen for my son and myself in case of anaphylaxis. I also carry benadryl for mild allergic reactions, like the one he gets when he's around dogs and gets itchy, breaks out in hives, and starts sneezing like crazy. Of course this is uncomfortable, but in this case, the symptoms do not progress into anything more serious, and benadryl is sufficient.
Allergic reactions exist on a continuum from mild to moderate and then severe/anaphylactic.
Anaphylaxis is a severe, life-threatening condition. Whenever anaphylaxis is suspected, the treatment is epinephrine (EpiPen, or similar) immediately and then you call 911. With anaphylaxis, time is of the essence, because the symptoms can progress rapidly. Therefore, swift administration of epinephrine is required. After epinephrine, the patient must be seen in the ER for continued observation and monitoring even if the symptoms seem to subside. This is critical because a secondary, or bi-phasic reaction can occur; these are severe, very serious, and much more difficult to control.
Benadryl is an antihistamine, and while antihistamines help with mild allergic reactions (e.g. mild itching or hives), they CANNOT stop or reverse anaphylaxis. Benadryl doesn't "buy time" with anaphylaxis and will not reverse the potentially fatal systemic respiratory or circulatory reactions that occur in anaphylaxis.
The first line of defense should be continual education and strict avoidance of allergens. Please go to The Food Allergy Research and Education website at www.foodallergy.org. This is absolutely the BEST resource for anyone with allergies or who has kids with allergies or works with allergic kids (teachers, coaches, etc.). It has an entire section on anaphylaxis and a helpful guide for staying safe while eating in restaurants and much, much more.
Are you working with an allergist? If your children's and your allergies are that severe, you really should be. Every allergist I know gives patients an allergy action plan that's like a flow chart that tells you exactly what to do, what to administer when certain symptoms are present. Our school district requires them for my son, and any other child who has an Epi-pen and benadryl at school. My son had to have one for summer camp as well. We have one at home for when grandmas are visiting or when we have a babysitter.
I cannot imagine anyone who has ever had an anaphylactic reaction not having an allergy action plan. Please, please talk to your allergist about this and get one for each of your children, and make copies to have at home, school, and to leave with any person who cares for them in your absence.
Also, please check out the website to review the signs and symptoms of anaphylaxis and assure yourself you'll know what to do in the event of another emergency.
All the best to you and your children!
J. F.
I've always been told that you must give the epi-pen at the first sign of anaphylaxis, then administer Benadryl if they're able to swallow. This is really important if two or more body systems (skin, lungs, gut, etc) are involved.
If anaphylaxis is allowed to progress too far, the victim's blood pressure will drop too low, making it impossible for an epi-pen injection to be effective. The injected epinephrine will just stay near the injection site and won't be circulated. I think this might have been why that person died recently-- they gave Benadryl first and waited too long to administer the epi-pens.
Epi-pens administer adrenalin, which is totally safe (unless you have some kind of major heart defect). Always give it first when in doubt!! And if a first injection does not show signs of reversing a reaction within 5-10 minutes, go ahead and inject using a second injector. Time is really of the essence.
And always call an ambulance after injecting! The epi-pens only buy you about 20 minutes of anaphylaxis reversal. Usually, at the hospital they'll want to give you an IV of a steroid, then watch you closely.
I carry the Benadryl single dose packages in my purse for my son. The doctor told us to try the Benadryl first. If he was unable to breathe, then we would definitely use the epi-pen. He is allergic to tree nuts (not peanuts). We have never had to use the epi-pen. I always give him a dose of Benadryl and the symptoms start to subside pretty quickly. It doesn't happen very often now because we are more careful about what he eats.
I tend to be trigger happy with Benadryl. If I see a hive, I immediately act. I don't wait and see what happens. I hope,to never use an epi-pen.
We go next month for testing, and I'm hopeful that my sons nut allergy will be gone. I doubt it, but I can hope :-)
I don't have an allergy child but I wondered - since an epi pen does not cure anaphalaxsis and you need treatment, what do they treat you with when you get to the hospital? If it's an antihistamine it would make perfect sense to take a Benadryl at first sign of exposure, even if an epi pen ends up being required.
I have liquid Benadryl in my purse at all times. I never go anywhere without it.
I keep liquid Benadryl and topical Benadryl cream, in addition to his Epi. Thankfully, we've never had to use his Epi, but Benadryl is my go-to.
ETA: Since this question is here, Epi-pen is celebrating their 25th anniversary by allowing download of a $100 coupon/voucher for a twin set. I called to look into a buy-back program to replace the expired pens that we have, and this is what they offered. If you need one, go to their website and print one out for yourself, and please forward this to others.
This 13 year-old girl died after having first been given Benadryl, then 3 doses from Epi-pens from her father, who is a doctor.
http://www.cbsnews.com/8301-204_162-57596190/13-year-old-...
I am allergic to Benedryl. I had an unexplained anaphylactic incident once and was given a shot of steroids when I arrived at Urgent Care instead.
Each patient and case may be different, so a doctor's advice would be best when devising a plan for a person with identified allergies.
I've had 2 ER doctors, an allergist, and a general practitioner recommend that I carry liquid Benadryl with me to slow down an allergic reaction to buy me time to get to the ER before I go into full anaphylaxis. I'm allergic to tree nuts, but have an autoimmune disorder which causes me to go into anaphylaxis occasionally for no reason - although it's usually when I'm stressed or there are high seasonal allergens in the air. Many, many, many times Benadryl has saved me from a full attack; and I've had 3 full attacks requiring hospitalization so I'm VERY familiar with the symptoms when they start.
I carry liquid Benadryl, an epipen, and albuterol. I also take preventative antihistimines daily (twice a day) and they have stopped the attacks. Of course if I eat a tree nut I'll go into anaphylaxis, but the preventative has stopped my random attacks.
I have one son with asthma and food allergies. His reaction to eating peanut butter was wheezing hours after ingestion, so we have not seen any immediate anaphylactic type reactions.
We carry two EpiPens, Benadryl single use packets, and an albuterol inhaler. If he has a mild allergic reaction like with his dog allergies, we do benadryl. If he has some wheezing, but can still breath and do regular activities, we treat with asthma medicine. If we think the wheezing is from an allergic reaction (as opposed to illness induced), we would also do Benadryl.
If at any time, he could not get a breath in or his face or neck looks like it were swelling, I would do the EpiPen first. We haven't had to do that yet and I hope we never have to.
I carry 2 EpiPens in case I screw the first one up. If you've never tried using a real EpiPen (as opposed to the tester one they give you), I recommend trying an expired one in an orange or something. It makes a click noise that may cause you to jump and pull the needle out too soon. I had my son's grandma try it and that was the very thing she did so I had her try another expired one so that she could practice doing it right.
I would carry everything necessary to protect my child. I also think there's so much to be said for the things that can be done to reduce the reactions and decrease the sensitivities. A dear friend has a child with a severe anaphylactic reaction to peanuts, and she also had less severe reactions to soy and egg. No one in the family could eat peanuts lest the little bit of dust or oil on their hands get on their clothing, and they installed a sink in their front hall so that anyone coming in the house could wash thoroughly!
In one year, with a comprehensive supplement, her numbers dropped 50%, and they dropped to 0 the following year. The egg and soy allergies are gone completely and she can eat those products. While her parents don't give her peanuts and may never do it, they can eat out, and the child can go to parties and friends' houses, with no chance of a reaction if she's near peanuts or even if she ingests trace amounts. I've seen a large number of others get the same results, so I would advise anyone in this situation to at least take the anaphylactic aspect out of the equation. Epi-pens and benadryl are good back-ups and of course I would carry them, but I know dozens of people who go through life, including travel, a lot more securely with the emergency aspect removed.
I carry an Epi-Pen for my 10 yr old.
YES! Well not recently only once!The school my son USED to go to gave him little bit of peanuts and the school had to inject it.One of the scariest day of my life.
I agree, Benadryl is a fast acting antihistimine that I would, if I ever had to, give along WITH the epi pen. They do separate things entirely.
My daughter (now 20) experiences anaphylaxis to peanuts. She practices strict avoidance, which is the best "therapy." This means that she reads every label and asks for a complete ingredient list when she eats out. She's found that most eateries are very good about checking to make sure that the food they will serve her is peanut-product free. At some upper-end restaurants, the chef will even come to the table to make sure that the ingredients being used are safe and will prepare her meal separately and personally.
If my daughter thinks she's had an accidental exposure, she takes benadryl immediately -- she doesn't wait for an allergic response to occur. She carries the quick dissolve strips, which will dissolve under the tongue and work effectively even if she can't swallow. If any symptoms progress at all, she self-administers epinephrine immediately, then heads to the ER. She always carries a twin-pack, in case a second shot is needed, and she makes sure that the pens are always up-to-date. Epinepherine is active if the solution is clear and should be discarded if it's begun to turn yellowish or hazy. Even so, she replaces her pens once/year when they reach the expiration date, regardless of the state of the solution.
One person asked how anaphylaxis would be treated in the ER if the epinephrine isn't effective. Anaphylaxis can cause collapse of multiple organ systems, so different drugs are used to treat specific responses as necessary. For example, pressors might be used to return vascular tone and raise blood pressure to normal or near normal in the event of cardiovascular collapse; breathing assistance might be necessary in the form of additional oxygen or a ventilator, etc. In a hospital environment under close observation, the medical staff can respond quickly if/as problems arise.
Not everyone who is allergic to tree nuts or peanuts (or other foods) will experience anaphylaxis. The extent of the allergic response a person will experience depends on the specific protein in the food to which the person is allergic. Only certain types of proteins are associated with anaphylactic reactions. If you or your child is allergic to one of those proteins, it is essential to practice complete avoidance and carry emergency benadryl and epinephrine at all times, and to wear an emergency alert tag and to keep emergency information available in your cell phone (paramedics will always check a phone for entries starting with ICE [in case of emergency]). Component testing is now available through one company, and it is reliable (go to http://www.pirllab.com/ for more information). As a disclaimer I do not work for the company that makes this test. (Actually, I work for a company that makes competing tests, but we cannot yet test for the peanut allergens, and most of our molecular testing is still only approved for testing outside of the US). Other foods that can commonly cause anaphylaxis are eggs, milk, fish, sesame, wheat, and fruits in the apple family (peach, cherry, plum, apricot). There are many more foods, however, than just these. Also, some people who can tolerate a food when it is eaten will experience anaphylaxis if the food is inhaled as a dry dust. Nut dust and flour dust are two examples of foods that can cause this type of response.
