Frequently Asked Questions about Allergy and Anaphylaxis

Frequently Asked Questions about Allergy and Anaphylaxis
1. Food allergies aren’t serious. True or False?
False. Food allergies can be deadly. Each year there are about 150 deaths from
severe allergic reactions to foods mostly because an epinephrine auto-injector was not
used, used improperly, or not used soon enough.
2. If a child is having an anaphylactic reaction I should see many signs and
symptoms and it will look like her previous reaction. True or False?
False. The symptoms can vary from person to person and even from episode to
episode in the same person.
An anaphylactic reaction can involve any of the following symptoms, which may appear
alone or in any combination, regardless of the triggering allergen:
Skin system: hives, swelling, itching, warmth, redness, rash
Respiratory system (breathing): coughing, wheezing, shortness of breath,
chest pain/tightness, throat tightness, hoarse voice, nasal congestion or hay feverlike
symptoms (runny itchy nose and watery eyes, sneezing), trouble swallowing
Gastrointestinal system (stomach): nausea, pain/cramps, vomiting, diarrhea
Cardiovascular system (heart): pale/blue colour, weak pulse, passing out,
dizzy/lightheaded, shock
Other: anxiety, feeling of “impending doom”, headache, uterine cramps, metallic
taste
Because of the unpredictability of reactions, early symptoms should never be ignored,
especially if the person has suffered an anaphylactic reaction in the past.
It is important to note that anaphylaxis can occur without hives.
The most dangerous symptoms of an allergic reaction involve breathing difficulties
caused by swelling of the airways (including a severe asthma attack in those who have
asthma) or a drop in blood pressure indicated by dizziness, lightheadedness, feeling
faint or weak, or passing out. Both can lead to death if untreated.
3. A child with anaphylaxis comes to you and says they feel “funny” and there is a
“lump in the throat” but you don’t notice any signs or symptoms of anaphylaxis.
You should wait and see. True or False?
False. If an allergic person expresses any concern that a reaction might be
starting, the person should always be taken seriously. Many people will feel symptoms

efore they are noticed by others. Children have unique ways of describing their
experiences and perceptions and allergic reactions are no exceptions. Precious time is
lost when adults do not immediately recognize that a reaction is occurring or don’t
understand what a child is telling them. When a reaction begins, it is important to
respond immediately, following instructions in the person’s Anaphylaxis Emergency
Plan. The cause of the reaction can be investigated later.
Because of the unpredictability of reactions, early symptoms should never be ignored,
especially if the person has suffered an anaphylactic reaction in the past.
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4. If a child is having an anaphylactic reaction you administer Epipen, Twinject or
Allerject before calling 911. True or False?
True. If you are alone with someone who is having an anaphylactic reaction,
administer their Epipen, Twinject or Allerject prior to calling 911. If there are other
people present, have someone else call 911 and report back to you while you stay and
administer the auto-injector.
5. You always lay a person down flat when treating them for anaphylaxis. True or
False?
True: To improve blood circulation, caregivers should lift the person’s legs above the
level of the heart, keeping the legs raised by putting something (e.g. a pillow) underneath.
They should keep the person lying down until emergency responders arrive or until the
patient has fully recovered.
If the person feels nauseated or is vomiting, lay the person on his or her side, head down,
to prevent choking on vomit
It is important that the patient not be made to sit or stand immediately following a
reaction as this could result in another drop in blood pressure.
6. It would be helpful to practice regularly with EpiPen/Twinject/Allerject
demonstrators so that you are ready for an emergency. True or False?
True. Studies have shown that patients, parents of allergic children, caregivers,
teachers, and even healthcare professionals often cannot correctly administer the autoinjector
when needed.

With proper training, people can successfully learn how to use an epinephrine autoinjector
with confidence. Auto-injector trainers (or demonstrators) are must-have
teaching tools that allow for hands-on learning.
It is beneficial for participants to role play an emergency situation, similar to practicing a
fire drill. This allows people to become familiar with the emergency procedure for
dealing with an anaphylactic reaction, identify areas of improvement, and increase
confidence in their ability to respond appropriately.
The auto-injector trainers look like the real devices but do not contain a needle or
medication. Practice with an auto-injector trainer (e.g. EpiPen,Twinject or Allerject)
allows people to become familiar with the administration technique.
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7. Epinephrine auto-injectors must be kept safely locked in the office until they are
needed. True or False?
False. Epipen/Twinject/Allerject auto-injectors should never be kept in a locked
location. Auto-injectors must be kept in locations that are easily accessible (e.g. not in
locked cupboards or drawers). These locations should be known to all staff members and
caregivers. Individuals at risk of anaphylaxis are advised to carry an auto-injector and
tell others where the device is kept, in case of an emergency. Many school administrators
ask parents to provide a back-up auto-injector that is kept in a central, unlocked area such
as the school office.
Many children learn to carry their auto-injector in a waist-pack or “fanny pack” by the
time they are in grade one or two. This will vary depending on the child’s development
and skill level, level of support provided and education of peers and caregivers.
Classmates and friends should be taught not to play with an auto-injector.
8. Many children are trained to look after themselves and can easily administer
their own epinephrine auto-injector. True or False?
False. No person should be expected to be fully responsible for selfadministration
of an epinephrine auto-injector.
Individuals may not physically be able to self-administer epinephrine when they are
suffering from a reaction.
They may be anxious about using a needle, may downplay the seriousness of a reaction,
or may not want to draw attention to themselves. They may also be confused.

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Assistance from others is crucial in these circumstances.
9. Even traces of food can cause anaphylaxis. True or False?
True. The body’s immune systems works in such a way that one protein
molecule can illicit an immune response. That’s 1/70,000 of a peanut. A very small
amount of a food allergen ‘‘hidden” in a food or a trace amount of allergen transferred to
a serving utensil has the potential to cause a severe allergic reaction. With certain foods
such as fish, the vapor or steam produced while cooking has been shown to contain
allergens which can trigger asthmatic reactions and anaphylaxis.
10. It is dangerous to give an epinephrine auto-injector (Epipen/Twinject/Allerject)
to a child with anaphylaxis if you are not entirely sure they are having an
anaphylactic reaction. True or False?
False. It is recommended that epinephrine be given at the start of a known or suspected
anaphylactic reaction. Epinephrine is the only treatment shown to stop an anaphylactic
reaction. When in doubt, give the epinephrine auto-injector!
Epinephrine is the first line medication that should be used for the emergency
management of a person having a potentially life-threatening allergic reaction.
In studies of individuals who have died as a result of anaphylaxis, epinephrine was
underused, not used at all, or administration was delayed.
Epinephrine is the only treatment shown to stop an anaphylactic reaction.
Common temporary side effects of epinephrine could be shakiness, increase in pulse rate,
sensation of a more forceful heart beat, dizziness, nausea and vomiting, headache, and
weakness.
Information taken from www.allergysafecommunities.ca Updated June, 2013