• Child friendly
• What is allergy?
• What we deal with
• Dedicated Sinusitis Facility
• Your allergy consultation explained
• How allergy testing works
• Fiberoptic assessment of nose, sinuses and throat (naso-endoscopy)
• What we test
• How an allergy test is recorded
• Children's allergies
• Immunotherapy: can allergy be cured?
• Information sheets

Food allergy: emergency intervention

Reactions to nuts & shellfish (or indeed any food likely to cause an allergic reaction) are graded in severity.

Grade 1 (mild):

Localised skin redness, ‘hives’, swelling of face, lips and eyes (but NOT internally), itch around the mouth.

Grade 2 (mild):

Widespread skin redness, large ‘hives’, swelling of face, lips and eyes.

Grade 3 (mild):

Same as 1 & 2 but with vomiting and/or diarrhoea.

Grade 4 (moderate):

Mild voice change or ‘tightening’ of the throat. Mild asthma.

Grade 5 (severe):

Severe breathlessness, feeling light-headed, too weak to stand and collapses. Goes unconscious.

Treatments of grades 1-3: oral/injection antihistamines (Zitrek, Piriton etc) should be kept on standby for children and adults who have experienced such symptoms. Check the drug expiry date; have an emergency supply at all times and keep a supply at school, in the car, with child minders or relations etc. Have a management plan typed and explained in advance. Don’t have anyone scrambling for antihistamines and instructions in a crisis situation.

Grades 4 & 5: self-injecting adrenaline (Anapen) is advised for the following groups:

• Where previous exposure produced any breathing problems.
• Where exposure was only of a trace amount (eaten or touched) and this produced a mild reaction. The sensitivity (and hence future risk) could potentially be greater than that implied by the response observed. For example, a child whose only reaction was large ‘hives’ of the head and neck after taking a trace of peanut may go on to have a severe reaction if he or she takes a large amount of peanut.
• Where there is ongoing asthma, regardless of the grade of any previous reaction.
• IF IN DOUBT, GIVE THE ANAPEN

Become familiar with the use of Anapen by practising with the Anapen trainer. Where your child is visiting, or at school, on holidays, at relations or whatever: make sure whoever is in charge knows when and how to use the Anapen. Let them become familiar with the training unit. Don’t have them scrambling for instructions in a crisis, make them aware well in advance what they must do. Make sure the Anapen is not out of date. Keep spare supplies at home, school, in the car etc. Have a crisis management plan typed and to hand. Give a copy to anyone looking after your child.

Ø Children with asthma and nut allergy are the most vulnerable: keep the asthma under control and don’t under-treat.