Anaphylaxis in children, Decalogue of action of the AEP

The health of the little ones is one of the biggest concerns that goes through the heads of the parents on a day-to-day basis. The integrity of minors is not always insured and there are times when it is compromised, either by a fall that causes a wound or illness that requires a visit to a medical center to determine its severity.

In both cases, it is important to act quickly and take the appropriate steps to avoid further complications. Therefore, from the Spanish Association of PediatricsAEP has developed a decalogue to deal with cases such as pediatric anaphylaxis. Some guidelines to follow step by step when one of these situations is detected.

What is anaphylaxis

From the Basque Association of Pediatrics anaphylaxis is defined as a severe systemic hypersensitivity reaction, sudden onset, potentially fatal. Suddenly develop symptoms that affect the airway, breathing or circulation that are usually associated with mucocutaneous symptoms. Most of the time, compensation mechanisms control symptoms that resolve in a few hours. It is estimated that only the 1% of episodes of anaphylaxis are fatal.

Anaphylaxis is usually manifested through the following symptoms:

- Abrupt appearance of cutaneous or mucous symptoms and at least one of the following.

a) Respiratory symptoms

b) Checked hypotension or symptoms of tissue hypoperfusion

- Two or more of the following, after exposure to a probable allergen

a) Cutaneous or mucous symptoms

b) Respiratory symptoms

c) Hypotension or symptoms of capillary hypoperfusion

d) Persistent gastrointestinal symptoms

- Hypotension or tissue hypoperfusion after exposure to a known allergen.

Decalogue of the AEP

For the parents to know a little more about this problem, the AEP has elaborated this decalogue with which to make more understandable these situations:

- Anaphylaxis is the most serious allergic reaction that can occur, it is quickly established and can cause death.

- The number of children who have an anaphylactic reaction is increasing considerably.

- The most important triggers of anaphylaxis in children are food (milk, egg, fish and nuts), hymenoptera (wasps, bees) and drugs (beta-lactam antibiotics).

- Symptoms usually appear in the first 2 hours after exposure to the allergen. Cutaneous symptoms are the most frequent, but there must always be two or more affected organs.

- The diagnosis of anaphylaxis is fundamentally clinical, although in some cases laboratory determinations (tryptase) may be useful.

- The treatment of choice is intramuscular adrenaline at 0.01 mg / kg (maximum 0.5 mg), which should be administered in the lateral part of the thigh, as soon as possible.

- Every child who has suffered an anaphylaxis should be referred to the hospital and remain for a few hours under observation. At discharge, it will be referred to a pediatric allergy unit, preferably to be evaluated.

- The child who has suffered an anaphylaxis and his family must have at least two adrenaline autoinjectors and know how to handle it. Also, they should always carry it with them.

- The pediatrician will indicate in writing the necessary measures aimed at preventing the risk of anaphylaxis and will give a protocol for action in the event of a reaction, both for the patient and his family, and for the school.

- The allergic child must always be identified and controlled in the school and its environment, and teachers must be trained in the use of the adrenalin autoinjector. It is advisable to bring a plaque or bracelet with QR code identifying the allergies.

Damián Montero

Video: Emergency - Anaphylactic Shock in a Child (Peanut Allergy)

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