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Clinical Reference Systems: Pediatric Advisor 10.0
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Severe Allergic Reaction (Anaphylactic Reaction)


An anaphylactic reaction is an immediate, severe allergic reaction to a bee sting, drug, food, or other item. The symptoms are:

  • wheezing, croupy cough, or difficulty breathing
  • tightness in the chest or throat
  • dizziness or passing out
  • widespread hives, swelling, or itching (If these symptoms occur without the symptoms listed above, your child is probably not having an anaphylactic reaction. However, hives, swelling, or itching often occur with other serious symptoms when a child has a severe allergic reaction.)
  • a previous severe allergic reaction to the same item.


  1. Call 911 IMMEDIATELY.

    Call the rescue squad (911) if your child is having difficulty breathing or passes out. Have your child lie down with the feet elevated to prevent shock.

  2. Epinephrine

    If you have an anaphylactic kit (Epi-Pen or Ana-Kit), give an injection of epinephrine (adrenaline) immediately. Epinephrine can save the life of your child. If in doubt, give it. Inject it into the subcutaneous (fat) layer of the outer part of the upper thigh.

  3. Antihistamine

    If you have Benadryl at home, give it. If not, see whether you have another antihistamine or cold medication containing antihistamine. If you do, give one dose immediately in addition to epinephrine.

  4. Bee sting treatment

    If a stinger is left in the skin, remove it. Do this by scraping the stinger off with a knife blade or credit card rather than by squeezing it. Then apply an ice cube to the site or a cotton ball soaked in a solution of meat tenderizer and water.


Children with anaphylactic reactions need to be evaluated by an allergist. Since the reactions can be fatal, you should keep emergency kits containing epinephrine at home and in the glove compartment of your car (epinephrine is available by prescription only).

Also, your child should have a medical identification necklace or bracelet that states the insect, drug, or food allergy. Some ID necklaces and bracelets can be found in pharmacies.

Written by B.D. Schmitt, M.D., author of "Your Child's Health," Bantam Books.
Copyright 1999 Clinical Reference Systems