How Do I Treat It If It Happens?
Several important steps can protect a patient with serious food allergies from having future reactions. These steps include:
1. Remove all sources of food that the patient is allergic to. Even trace amounts of a food protein can cause a severe reaction in some people. It can be particularly challenging to avoid foods that frequently show up in food items as hidden ingredients, such as peanuts. Therefore, always read food labels carefully before purchasing a food item. Companies are required to clearly label any product that contains even small amounts of a food product. Periodic alerts published by the Food Allergy and Anaphylaxis Network are very helpful in updating patients regarding hidden sources of food allergens.
2. Be careful when dining out. Most inadvertent exposures to allergenic foods occur while eating in restaurants or in friends’ homes. When you eat at restaurants, always check to make sure that food ordered by the allergic patient was not cooked in the same pans, oils, or utensils used to prepare foods that are allergenic to that patient (i.e., cross-contamination). Tell everyone who handles the food that the allergic person eats, including waiters in restaurants and cafeteria workers at school, about the food allergy. If the manager or owner of a restaurant cannot accommodate your request for allergen-free food preparation, you probably should not eat there.
3. Do not eat foods with an unknown list of ingredients. For children with food allergies, it is very important to make all lunches and snacks that are taken to school or any outing away from home. 4. For children, talk to the day care supervisor or school principal, and work with the school and family friends to create a food allergy emergency action plan.
5. Wear a Medic-Alert bracelet to identify yourself as having a life-threatening allergy to food.
6. Epinephrine is the single most important treatment for food-induced anaphylaxis. People with histories of systemic reactions to foods should have epinephrine available at all times, including in their backpack or purse, home, school nursing office, and car(s).
A very convenient method for injecting epinephrine is the EpiPen Autoinjector?. By pressing the pre-loaded injection device firmly against the thigh, a measured amount of epinephrine is injected through fabric and into the muscle. It is available as an EpiPen Jr? (0.15 ml for children weighing 33 to 66 pounds) and EpiPen (0.30 ml for patients weighing more than 66 pounds). Other commercially available devices for injecting epinephrine include the AnaPen?, Ana-Kit?, and Twinject?.
Epinephrine should be administered imme-diately when a person first begins to experience a systemic allergic reaction to a food. In addition, if a person realizes that they have just ingested a food that they are highly allergic to, they should administer the epinephrine prophylactically to avert a major reaction. Oral anti-histamines are not an effective means of treating or preventing a systemic allergic reaction to foods.