Do not delay administering an EPI

“My child isn’t that allergic.” This is a common response when I tell people that an EPI pen must be given immediately for it to work properly. The parents will usually tell me that Benadryl has been enough in the past or that the child vomits and all is well. Unfortunately, in each tragedy, from Natalie Giorgi to BJ Hom, the families were also not prepared to inject the child with an EPI immediately (and I get it – it is really scary to stab your kid with an EPI pen). In Natalie’s case, they waited only 20 minutes after giving Benadryl. By then it was too late. In BJ Hom’s case, they didn’t realize what was happening until it was also too late.

I am guilty of it myself. When my son was 4, he accidentally ingested a taste of milk. I gave him Benadryl AND Zyrtec. No effect. So I called my Allergist. God bless her, she picked up while she was driving, pulled over and yelled at me to “give him the EPI NOW”. And then when my son (who at first said he didn’t want the EPI) asked for the EPI, I knew it was bad. But I thought I had time, so I called my husband to let him know that I was going to use the EPI BEFORE I USED IT…Everything probably took 6 minutes from ingestion to injection. Thankfully, I was in time. 2 months later, Natalie Giorgi died. I had a panic attack as I read her story. That could easily have been us – her mom did what I did: started with the Benadryl since Natalie didn’t pose any initial symptoms other than it tasted weird, and she had spit it out. Her mom had said that Benadyrl had always been enough…. The allergen had just touched her tongue…. She hadn’t had an issue in years, and she had never had a serious issue…. In contrast, I had had a serious issue, and a mild issue, with my son, but since he hadn’t had an issue in over 2 years at that point, my first instinct was also to just start with Benadryl – why start with the EPI that would make his heart rate spike??? (The EPI acts like a massive amount of adrenaline to push the allergen out of your system.) I was lucky, I administered the EPI before his body shut down; sadly, Natalie was not as lucky even after being given 3 EPI injections by her dad (who is also a doctor).

I keep my son safe now by being vigilant about his food and carrying an EPI with us wherever we go. But what happens when he is a teen?  Teens are on their own more and use their own judgment (or lack thereof), making teens even more susceptible to have a possibly fatal allergic response. These kids’ parents have safe guarded their food and protected them, and the teens are (naturally) tired of dealing with food allergies and worrying about every bite they take, and since most haven’t had an issue in years (because the parents have been careful), the teens tend to get lax…. Parents can’t let down their guard to teach their kids a lesson, but they must teach their children how to be careful with their food, and teens need to be told they must carry an EPI (even if it is a pain) and use it immediately, no matter what. Unfortunately, even if it is tiring and a nuisance, they need to understand that vigilance is their best hope at staying alive.

My Allergist has told me that a body can respond 1000 different ways to the same food that you ingest 1000 different times. And since you never know when is the time that your body (or your child’s body) will decide to go into anaphylactic shock and when it won’t, you have to err on the side of safety and give the EPI within minutes. Once the body goes into shock, there is nothing that can be done, not even in an ER.

 

 

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