Allergic reaction (Urticaria)
 
Identifying an Allergic reaction:
  • Generally appears as a red lesion on the skin, the skin is raised by a few millimetres and is very itchy.
  • Run your fingers gently along the lesion to confirm an allergic reaction.
  • Itching is a common occurrence during an allergic reaction but not always. Itching could also sometimes be caused by other factors and should be diagnosed differently.
  • The appearance of the lesion depends on the area of exposure (mostly). For eg. Skin.
  • If the child has consumed the allergic substance, it can present itself as swelling/ redness over/near the mouth.
Seek medical advice if:
  • The reaction is severe accompanied by pain and discomfort
  • There is swelling of lips or the mouth
  • There is noisy breathing or discomfort while breathing
  • There is discolouration of urine
  • You suspect other causes/ Complications.
Treatment
  • In mild cases, treatment is generally not necessary. It usually subsides in a few hours.
  • If moderate reaction/ discomfort, start oral antihistamines ( Chlorphenamine/ cetirizine) which are over the counter medications.
  • A short course of steroid tablets (oral corticosteroids) may occasionally be needed for more severe cases.
  • Adrenaline injections may be given in the hospital if there is a severe reaction.
  • Meet your paediatrician if you are worried about the extent of the reaction.
  • In severe reactions (anaphylaxis) you will be given Adrenaline auto-injector (a pen device with adrenaline)
Investigations
  • Skin prick test can be done to find the suspecting allergen.
  • Small quantities of allergen are injected into the skin and the reaction is analysed.
Complications (Immediately consult your doctor if any of the below are present)
  • Angioedema( swelling in the deeper layers of skin)
  • Anaphylaxis (swollen eyes, lips/ breathing problem/ vomiting/ unconsciousness)
Using Adrenaline auto-injector pen (EPI-PEN, JEXT)
  • It is a pen-like device containing Adrenaline in chemical form to treat severe allergic reactions.
  • It is important that you use the auto-injector correctly so that the adrenaline is delivered into your muscle and works quickly. Ask for training from your doctor or nurse on how to use your adrenaline auto-injector.
  • Carry two injectors with you at all times.
  • The first dose should be given immediately and the second dose can be repeated after 15 minutes if symptoms don’t improve. Call for an ambulance immediately after the first dose.
  • Your family members, carers or teachers should also be instructed in the correct use of the auto-injector. Wear a band instructing your condition.

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