Have you ever had to use an epi pin on your child or yourself?

[Natalieclare]

How did you know when it was time to use it?

 

My 3 yos ate some pitted cherries the other day. He started to choke on the cherry, then spat it out. Even after he spat out the cherry, he seemed to have trouble breathing and had a raspy voice. I kept asking him if he could breathe, and he would gulp in air to show me he could. But every time he gulped in air, he would cough and sound like his airway was sort of tight. Except, it could have just been juicy since he had just gotten done choking. I didn't know what to do. He's never had an allergic response, but my husband is severely allergic to cherries, so I was kind of on the watch for anything amiss.

 

We have an epi pin for another child's allergies, and it crossed my mind to use it.

 

How did you know the reaction had gotten severe enough to warrant the use of the epi-pin?

[TwinMominTX]

Yes - I have a severe allergy to fire ants. I've used an epi pen on myself three times. My personal threshold is when my mouth/throat or breathing is becoming affected in any way.

 

Additionally, I will now use it when more than one system is being affected - for example, if my eyes swell and my lips swell, or if my scalp itches and my eyes swell. My most recent reaction was very very scary and I will now be more liberal in my decision to use my epi pen. In most cases of allergic reaction it can't hurt and the consequences of not using it can be very very serious.

[Dana]

I used an Epi on my son in the car on the way to the ER. One thing I learned was to practice on someone else. The arm movement is very different when injecting someone else than when injecting yourself. I had to attempt it twice since I didn't hear the "click" the first time.

 

We probably should have given it earlier.

We saw no signs of an allergic reaction; we just had our son (at age 5) telling us that he thought he was having an allergic reaction and his throat felt scratchy. We gave Orapred and Benadryl and were in the car on the way to the ER when his voice started getting a bit hoarse and he vomited. That was when I gave the Epi. There were no visual symptoms of a reaction. Hives didn't break out until about 6 hours after the initial reaction.

 

Check with your son's allergist, but since your husband is allergic, I wouldn't be giving the kids cherries. It also sounds like this could have been a reaction. Our allergist has said give the Epi, then call 911 and get an ambulance. Giving the Epi when you don't need it is okay (especially with kids; it's slightly more risky with adults due to heart issues) but not giving it when you do need it can be fatal.

 

Allergies are tough. With your situation, since there was choking on a pit, hoarseness can be just due to recovering from coughing. It may be worth getting allergy tests done.

[Ali in OR]

It sounds like this child has not been diagnosed with allergies? The epi-pen was for a sibling? This doesn't really answer your original question about what to do in an emergency, but now that the emergency has passed, I would take the child in to see the doctor to find out if they have the same allergy issues that other family members have and then to establish a protocol for this child the next time an emergency arises. We don't deal with allergy issues, but we do need to go through a decision making process for treating my dd's seizures. It's nice to have a protocol in place to know what to do in an emergency situation. It helps you think clearly during those times. Protocols are different for different kids-what we need to do for our dd with seizures is different than what other friends need to do for their dc with seizures. I don't know about epi-pens, but maybe a 3 yo has a different dose than an older sibling. I would not have wanted to use medication not prescribed for this child (aren't epi-pens prescription?); I would probably go to urgent care if I thought he was having a reaction.

[FaithManor]

My dd, a paramedic student, also said that when in doubt, call 911 and tell dispatch that you have the epi but are very unsure...there are some not common but also not necessarily rare side effects of epi and so there is a little concern about giving it when there isn't a reaction. But, the dispatcher should be able to put you through the the medical director (a doctor) or one of the head paramedics. DD just went through extensive training on the presentation of allergic reactions that don't look like allergic reactions as the general public thinks of them. They can say, yes administer the epi, no wait - we are right around the corner and we'll be there in a second, no this isn't life threatening, or administer now and we will be there as soon as we can or head to the hospital and we will meet you at intersection blah, blah, blah.

 

Yes, if you are in a rural area, some ambulance services will have the paramedics meet you at some point in route to pick up the patient in order to get that person to the ER more expeditiously. They won't do it if there is any chance of back or bone injury but for something like an allergic reaction, suspected stroke, etc. if response time is 20 minutes out, they'll meet you on the way.

 

So, please, don't be afraid to call dispatch...they can put you in touch with the people "in the KNOW" and you can't always expect the doctor's office to be in that loop. Since many doctors are not ER doctors and don't deal with field trauma and every second counts/life or death decisions, their knowledge (especially if they are more than four years out of med school) may be old. Your EMS medical director and the paramedics probably have more up-to-date information.

 

Faith

[sbgrace]

If you look at statistics most who die of anaphylaxis did get an epi pen at some point. But they got it too late in the reaction. And to my surprise too late is pretty early into it. The most effective time to give in epi pen is very early into the reaction. The take home for me was waiting until I was certain/things got worse/breathing was affected/etc. was potentially deadly.

 

Our plan says epi for any known exposure with the ana item or any two body systems affected. Epi, then 911, then benadryl. The most deadly reactions are actually blood pressure drops and time is imperative there. A significant portion of anaphylactic reactions never have hives/skin involvement. Anyway, I've never used it with my son but in retrospected we majorly messed up with his anaphylaxis and I hope I'll follow protocol if we're ever faced with it again.

 

And....reading your description I wouldn't have known if that was anaphylaxis either! I probably wouldn't do cherries again unless you can test him first but I can't tell that was actually a reaction. Side note: why was your son eating cherries if your husband is severely allergic to them?? If he's actually anaphylactic I wouldn't want them in my home let alone in my child's mouth (whom hubby might kiss?) I'm a little confused or maybe I'm misunderstanding. But my further understanding is that you can inherit a propensity to allergies general but you do not inherit allergies to specific foods. So your husband's cherry allergy does not mean a child of his is more likely to have a cherry allergy compared to the general population. My son's tree nut anaphylaxis doesn't mean his brother or a future child is at increased risk to react to nuts. A future child might inherit allergies though.

Edited July 10, 2010 by sbgrace

[rafiki]

.

[Dana]

You just know, it's that bad and scary!

...

There was not one doubt either time.

 

However, there have been many other smaller reactions, single symptoms and I'm always on edge, will it stop with this symptom?????

 

We did not know with our son's anaphylaxis. My husband even questioned him when he said he thought he was having a reaction since it was so different than what we'd seen before and to nuts which we thought were safe.

 

We were on the way to the ER "just in case" and we did not have 2 symptoms together. It was just my son's report of a scratchy throat and him saying he thought he was having a reaction.

 

By the time there was no doubt, if we hadn't already had the Orapred, Benadryl in him and Epi handy, he may have died. We got lectured a couple of times about calling an ambulance instead of driving ourselves - but we didn't know it was an allergic reaction at the time we left the house!

 

I still get panicky when remembering that day :(

 

So for us, it wasn't obvious.

[nova mama]

I don't know about epi-pens, but maybe a 3 yo has a different dose than an older sibling. I would not have wanted to use medication not prescribed for this child (aren't epi-pens prescription?); I would probably go to urgent care if I thought he was having a reaction.

 

Epi pens come in adult (DH has one) and children's doses. We once used it on DD4 (age 2 at the time), but it was actually a sibling's prescription. Three of my children have allergies, but we don't have a pen for each child. (I know, we probably should!)

 

I have been told to err on the side of using it. The wisest thing is probably to call 911 and get their advice (as someone else suggested), but I don't think you should wait until you get to urgent care. If it turns out that you are in fact dealing with anaphylaxis, you have a few minutes, maybe seconds?

 

Also, if you do use one, you still need medical attention. There may still be some effects of the allergic reaction after the medicine wears off. When we gave it to DD, the doctor wanted us to stay in the ER for 6 hours afterwards to make sure she was OK.

 

There's more info about dosage, etc. at http://www.epipen.com/page/epipen-and-epipen-jr-dosing--epinephrine-dose--anaphylaxis.

[naturegirl7]

If he was truly choking - the raspiness and soreness is most likely from the choking itself. I choked as a kid and needed the H. manuver to clear my airway. It HURT. MY throat was sore for all that day and even the next....

 

That said, I have ana allergy to latex and my son has ana allergies to peanuts and soy (on contact to both). We have been blessed in that we have not needed to use our epis. I have given him double doses of benadryl on many occasions though. We carry homeopathic allergy meds, 4 doses of benadryl, and 2 epis EVERYWHERE with DS.

 

One epi will give you about 15 minutes of airway relief, then you need another dose. Most people will need atleast 2 doses of epi before they even reach the hospital whenthey have a true ana reaction. You also need to consider that they should be keeping you for observation for a minimium of 4 hours after any allergic reaction - about 4 hours after the initial reaction many people have a "rebound reaction" the meds wear off and the ana cycle restarts, often it cn be MORE severe than the initial reaction itself. And be sure you use an Epi Jr on kiddos - the adult epi would have waaaaay too much epi in it to be safe.

 

That said - we have had a few close calls, but we were taught to give a double dose of benedaryl to start (fast disolving strips or tabs only), wash him up really well (since it is contact based) and monitor closely. We have had DS break out in hives multiple times - a few times he had sneezing and very slight wheezing too (those times I was prepared to give the epi and would have given it if he ingested any allergen). Again the double dose of benadryl was enough - but often had to redose in 4 hours...

 

We were taught airway issues OR 2+ systems involved can warrant an epi - like if he broke out in hives/facial swelling and then started vomitting - that would warrant an epi injection even those theorically his airway would be okay for the time being. Ana reactions can progress SUPER FAST - call 911 if you are unsure, or even think you need to give it - the sooner 911 gets on the scene the better when ana reactions are involved....

[Hunter's Moon]

When I was 6yo my mother had to use it on me because we were making peanut butter pine cones for the squirrels. We didn't know I couldn't touch it, we just knew I couldn't eat it.

 

I get allergy shots and they give me hives where they shots were. I asked the woman when the doses go up, will the hives turn into an allergy attack? She said usually not, but if I get scared and use the epi-pen, it doesn't matter, I'll just feel very shaky and such. It won't bother the child if used when not needed. I would still go to the hospital even if the reaction wasn't bad and I used it though just so they could make sure my heart rate wasn't too high and such.

 

So, when in doubt, any at all, I would use it.

[NoPlaceLikeHome]

I was taught to use epi pen if child presents with more than simple hives such difficultly breathing, throat tightness, swelling tongue, nausea/vomiting, distress, etc. My allergist told me if they are their happy, usual self and only have hives, then epi-pen ready and give benadryl. If any other symptoms or distress, then immediately give epi-pen and call 911 and ask for advanced cardiac life support ambulance. When in doubt, give epi-pen.

 

 

http://www.foodallergy.org/files/FAAP.pdf

 

I was worried about giving it unnecessarily and the doctor said they the problem is people usually wait too long to give it:( Plus the epi-pen will only make them jumpy for a little while and not hurt them.

 

http://www.foodallergy.org/

[NoPlaceLikeHome]

I used an Epi on my son in the car on the way to the ER. One thing I learned was to practice on someone else. The arm movement is very different when injecting someone else than when injecting yourself. I had to attempt it twice since I didn't hear the "click" the first time.

 

 

 

I would only practice with the trainer and notn the actual epi-pens on soemone else. I do save expired epi-pens to shows others (with great caution) how to use it on an orange after they have practiced with the trainer. Then you can very carefully place the epi-pen back into the plastic container they come in to safely dispose of.

 

I also discuss strategies on how to give. For example, if able place patient quickly in side lying position on floor/bed/couch and give. Maintain side lying position if able since they may vomit. Do not place them like this if it delays treatment with epi-pen since every minute counts IMHO. You can give epi-pen through clothes.

 

I also recommend anyone to take CPR and First Aide classes if you have a loved one with food allergies since First Aide Class covers epi-pens usually.

[NoPlaceLikeHome]

http://www.epipen.com/

[Dana]

I would only practice with the trainer and not the actual epi-pens on soemone else. I do save expired epi-pens to shows others (with great caution) how to use it on an orange after they have practiced with the trainer. Then you can very carefully place the epi-pen back into the plastic container they come in to safely dispose of.

 

Absolutely! I'd just never thought to practice with the trainer on my husband. After the reaction, I made sure that anyone who watched my son showed me that they could use the trainer on me.

 

I was so glad I'd practiced with the trainer enough and had read the information so I knew that since I didn't hear the "click", the Epi hadn't injected.

[Mandamom]

This is interesting conversation because I'm now questioning whether or not I should keep an epipen for me.

 

About 8 years ago I started having system allergic reactions to poison ivy -- a contact poison ivy spot (the typical blistering rash) would result in a different rash all over my body and prednisone was the only thing that would clear it. A few years later I had a small contact with poison ivy and the same thing happened. I try very hard to avoid the ivy but 2 years ago, I apparently came in contact with it and got a small blistering rash on my elbow and went to bed with no problems. when I woke up the next morning my eye, face and neck were swollen. I did not get a secondary rash this time but I needed the predinosone to clear the swelling. I ask because although the swelling didn't affect my breathing at all I wonder if I run the risk of that being a problem the next time I'm exposed to small doses.

 

BTW I have no insurance.

 

Thanks.

[Natalieclare]

Thanks for all your stories and replies, friends. I am just now able to have the time to post again.

 

(I have GOT to figure out the multi-quote thing. Arg--I feel so silly not using it at this point.)

 

Anyway, the halved cherry my son choked on had had the pit removed, so I knew it wasn't the pit that caused him to choke. And I think it was just the choking itself that made his voice scratchy.

 

My husband is a pediatrician, and I confess, I am very dependent on him for medical things. Sometimes I forget obvious things like calling 911 when I have a medical question because I am so accustomed to letting him doctor us. However, he was at work, unable to answer his cell, when this happened.

I just panicked and thought "Do I use that epi-pen? How do I *know*?"

 

We only have the epi-pen because my oldest son receives his allergy shots at home. His allergies are all environmental, so I have never had to learn protocols or anything. My heart goes out to you moms and dads who must be so vigilant.

 

This morning we gave Milo some cherries and he did just fine, which is what led me to believe it was just the choking that produced the funny voice thing.

 

Hearing about how quickly the epi must be used makes me want to carry one in my purse at all times. Why doesn't everyone? Years ago, a dear friend of the family died from a bee sting, though he had been stung in the past with no reaction. I've often thought, would he have been spared if he had an epi around? I am going to ask my dh about this.

 

Thanks again for your replies. It's been very eye-opening for me.

Edited July 12, 2010 by Natalieclare

[ThatCyndiGirl]

None of my kids have allergies.

 

But,...I had to use an epi-pen on myself once. I still don't even know what triggered the reaction, but it was scary.

 

Another time they administered it in the ER and I guess they gave me too much because my heart was racing so much I thought I was going to die.

 

It was less than fun.

 

Apparently, chubby women look like they need a LOT of epinephrine. :glare:

[Ann]

I know here that you can buy an epipen without a prescription your insurance just won't reimburse you the money.

[lisamarie]

Who would have thought that reading this thread just a few days ago would possibly save my kid's life??? My DS is allergic to eggs, tree nuts and peanuts and we have an epipen for it. He's never needed the epipen, never reacted beyond the point of benadryl or prednisone. But tonight during dinner, DS said his mouth hurt. We thought it was just too spicy for him so I had him drink some milk. His face then started turning beat red, he was getting even more upset, and I noticed that his face was starting to swell up. He started drooling and was slurring his words.

 

I called my FIL who is a dr and he said to dose him with benadryl, which I did. But then I remembered this thread, that if there were 2 systems affected, to give him the epi and that I needed to do it right away and not wait too long, so I gave him the shot. FIL arrived with some prednisone and gave him some of that. DS threw up and then DH took him to the ER with a spare epipen just in case. (We live about 10 minutes from the hospital so he was still within the 15 minute window)

 

It turned out okay, but it sure did scare the heck out of me. The only reason I could even think straight despite my panic was because I'd read this thread and all the advice on WHEN to give an epipen. I've always been afraid to use it even when I should have (on myself due to shellfish allergy). I'm glad I didn't listen to my DH to wait on the epipen because I know DS needed it and that waiting could have cost my DS his life.

 

I keep thinking I should buy DS a little fannypack of some sort so he can carry his epipen and inhaler around with him at all times because we've been in situations before where he needed his inhaler and didn't have it. I can't imagine what would have happened tonight if we hadn't had an epipen on hand.

[FairProspects]

Who would have thought that reading this thread just a few days ago would possibly save my kid's life??? My DS is allergic to eggs, tree nuts and peanuts and we have an epipen for it. He's never needed the epipen, never reacted beyond the point of benadryl or prednisone. But tonight during dinner, DS said his mouth hurt. We thought it was just too spicy for him so I had him drink some milk. His face then started turning beat red, he was getting even more upset, and I noticed that his face was starting to swell up. He started drooling and was slurring his words.

 

I called my FIL who is a dr and he said to dose him with benadryl, which I did. But then I remembered this thread, that if there were 2 systems affected, to give him the epi and that I needed to do it right away and not wait too long, so I gave him the shot. FIL arrived with some prednisone and gave him some of that. DS threw up and then DH took him to the ER with a spare epipen just in case. (We live about 10 minutes from the hospital so he was still within the 15 minute window)

 

It turned out okay, but it sure did scare the heck out of me. The only reason I could even think straight despite my panic was because I'd read this thread and all the advice on WHEN to give an epipen. I've always been afraid to use it even when I should have (on myself due to shellfish allergy). I'm glad I didn't listen to my DH to wait on the epipen because I know DS needed it and that waiting could have cost my DS his life.

 

I keep thinking I should buy DS a little fannypack of some sort so he can carry his epipen and inhaler around with him at all times because we've been in situations before where he needed his inhaler and didn't have it. I can't imagine what would have happened tonight if we hadn't had an epipen on hand.

 

I'm glad he's okay! My ds went into anaphalyxis today too after the allergy pricking test. It was very scary, but we live 5 minutes from the doctor and they were able to get it under control with benadryl & prednisone, although the Epi was on everyone's mind during the reaction. It is so scary how fast a reaction can occur. We have been so lucky that both times ds has reacted we were near medical help. It is can be a frightening world with severe allergies!

 

I'm so glad both our dc are safe! Now go relax - I know exactly how stressed out you must be because I had the same kind of day! :grouphug:

[Dana]

Who would have thought that reading this thread just a few days ago would possibly save my kid's life???

 

I'm glad he's okay! My ds went into anaphalyxis today too after the allergy pricking test.

 

:grouphug:

 

So glad both your sons are okay!

 

We go for our second round of skin tests tomorrow. The first one was rough and showed that the dairy allergy is still very severe :( But at least we know it's still there and know not to slack off.

 

LisaMarie - we carry our son's medications in a fanny pack. Two epis, an inhaler, benadryl, and orapred. (sigh) We don't leave the house without it and we've got it in one location in the house as well. I'd like to get to a point where my son can do one of the smaller epi carriers that straps to your leg or around your waist when he's older and more on his own, but for now the fanny pack does work well. He was even responsible enough to take it with him when he "ran away from home" a couple years ago :)

[NoPlaceLikeHome]

Who would have thought that reading this thread just a few days ago would possibly save my kid's life??? My DS is allergic to eggs, tree nuts and peanuts and we have an epipen for it. He's never needed the epipen, never reacted beyond the point of benadryl or prednisone. But tonight during dinner, DS said his mouth hurt. We thought it was just too spicy for him so I had him drink some milk. His face then started turning beat red, he was getting even more upset, and I noticed that his face was starting to swell up. He started drooling and was slurring his words.

 

I called my FIL who is a dr and he said to dose him with benadryl, which I did. But then I remembered this thread, that if there were 2 systems affected, to give him the epi and that I needed to do it right away and not wait too long, so I gave him the shot. FIL arrived with some prednisone and gave him some of that. DS threw up and then DH took him to the ER with a spare epipen just in case. (We live about 10 minutes from the hospital so he was still within the 15 minute window)

 

It turned out okay, but it sure did scare the heck out of me. The only reason I could even think straight despite my panic was because I'd read this thread and all the advice on WHEN to give an epipen. I've always been afraid to use it even when I should have (on myself due to shellfish allergy). I'm glad I didn't listen to my DH to wait on the epipen because I know DS needed it and that waiting could have cost my DS his life.

 

I keep thinking I should buy DS a little fannypack of some sort so he can carry his epipen and inhaler around with him at all times because we've been in situations before where he needed his inhaler and didn't have it. I can't imagine what would have happened tonight if we hadn't had an epipen on hand.

 

I am training ds son to carry his epi-pens, benadryl, etc, in a fanny pack I still always carry a set, but I want him to learn to always have it on his person.

[lisamarie]

LisaMarie - we carry our son's medications in a fanny pack. He was even responsible enough to take it with him when he "ran away from home" a couple years ago :)

:lol: That made me laugh! I need to do this with my DS from now on. We've been in too many situations where we didn't have the inhaler he needed or couldn't find it, etc. When we were on vacation last month, he had an attack after swimming in the hotel pool. I could not for the life of me find his inhaler. My BIL was there so I ran to find him and borrow his inhaler but he couldn't find his. My sister ended up cracking out my nephew's nebulizer and gave my DS a breathing treatment. The next morning I found his inhaler in our day cooler pocket. So frustrating.

 

 

I am training ds son to carry his epi-pens, benadryl, etc, in a fanny pack I still always carry a set, but I want him to learn to always have it on his person.

 

I will buy one of these today and do this. I never thought it was super necessary before since we've had an epipen since DS was a baby but never had to use it until last night. I figured he just wasn't as bad as the allergist seemed to think he was. WRONG!

[lisamarie]

I'm glad he's okay! My ds went into anaphalyxis today too after the allergy pricking test. It was very scary, but we live 5 minutes from the doctor and they were able to get it under control with benadryl & prednisone, although the Epi was on everyone's mind during the reaction. It is so scary how fast a reaction can occur. We have been so lucky that both times ds has reacted we were near medical help. It is can be a frightening world with severe allergies!

 

I'm so glad both our dc are safe! Now go relax - I know exactly how stressed out you must be because I had the same kind of day! :grouphug:

 

I'm so glad your DS is okay. I hope to never have this experience again. I am still trying to not overreact and baby him today. He slept in this morning and it was very hard for me to not go poke him awake just to make sure he'd wake up.

 

Did you also check on him 3 times overnight like I did just to make sure he was still breathing? I had a real hard time letting DS sleep in his own room last night because he sleeps on a different floor than us. I was afraid the meds would wear off in the middle of the night, the he'd rebound, and he'd be yelling for me and I wouldn't hear him. He got up 3 times to goto the bathroom so I was able to relax some--all those fluids they pumped him full of in the ER ended up working to my advantage.:tongue_smilie:

[Dana]

Did you also check on him 3 times overnight like I did just to make sure he was still breathing?

 

Only 3 times? You're doing great!

 

With my son's anaphylaxis, they admitted him to the hospital overnight since he had a biphasic reaction (throat closed first, then about 4-5 hours later (when they were getting ready to release him from ER), the hives broke out). I'm still cranky with the hospital since they sent him breakfast that has food he's allergic to. He wasn't able to eat anything since I didn't trust them once they sent up a tray with milk on it.

 

In some ways, you can look at this experience as a blessing because now you know you can use the Epi when you need it, your son will likely remember this and take his allergy more seriously, and you know how severe his allergy is and won't be caught out without the Epi. (Of course, this is all much easier said than done.)

 

Off for our second skin test. Sigh.