Recognition and Treatment of Reactions:
The key to every reaction is recognition. You must understand how a reaction can present itself - and unfortunately, it is not always obvious.

Symptoms vary from child to child and reaction to reaction. No two reactions are identical, and predicting the outcome is impossible. Remember hindsight is 20/20 - but foresight prevents regret. Always be prepared and react quickly!

Typically symptoms appear within 30 minutes of exposure but can appear as long as 2 hour later. Upon onset, a reaction will last an undetermined amount of time, but usually worsens for the first 11/2 hours. The reaction may retreat upon medicating, or it may continue to escalate into full-blown anaphylaxis.

You must always receive immediate emergency treatment for these reactions, no matter how mild you feel it may be. You may determine the reaction has diminished, but there is a very real risk of a secondary (biphasic) reaction that could be even more dangerous than the first. Biphasic reactions do not always respond to treatment as well as the initial reaction does.

It is strongly recommended that you remain at the hospital for several hours after the initial reaction has been controlled to ensure a biphasic reaction is not coming on.

A biphasic reaction is a rare occurance - but definately something to be aware of. Many hospitals will send you home once the symptoms seem under control. Always do what you feel is best for your child.

What is an Allergic Reaction:
This is an area where there are some conflicting opinions, but for the most part, the following is agreed upon as to what an allergic reaction truly is. I am not going to bore you by examining every single item present in an allergic reaction, just the basics. There are many excellent resources that drill-down to every single layer.

An allergic reaction is your body’s immune system over-reacting to an otherwise harmless entity. In this case, peanut or tree-nut protein. The immune system is there to defend your body from infections, bacteria and viruses, among other things. Substances that are introduced that your body deems foreign are attacked and destroyed or neutralized by your immune system.

It is thought that during an allergic reaction, your immune system produces immunoglobulin E, or IgE. IgE is an antibody specific to the allergen, in our cases, the peanut/tree nut protein that offends it. The IgE antibodies latch onto the body’s mast cells, which are located in the organs and tissues. Upon the next exposure to the allergen, your immune system recognizes the allergen and the now sensitized mast cells bind to the offending protein and cause a release of histamine and inflammatory chemicals into the blood.

Histamine is then circulated throughout the blood stream and into the body tissues where it then attaches itself to the tissues by receptors. This process results in changes and reaction of the tissue. The levels of reaction affect the nose, eyes, lungs and gastrointestinal tract to name a few. The most fatal reaction is that of the cardiovascular system as the reaction causes a huge drop in blood pressure, causing shock and perhaps death.

Symptoms to Watch For:

It is important to note that these can present as simply one symptom, or in groups - one symptom could be warning that many more are on their way - do not wait for the reaction to worsen before you treat it - treat it immediately!

• Itching all over
• Hives, blisters, redness on skin (can be apparent anywhere on body)
• Quickened but faint pulse and heart palpitations
• Generalized swelling under the skin – this is due to fluid escaping from the blood vessels into the tissue
• Tightness in throat
• Difficulty in breathing, speaking (hoarseness), and swallowing
• Coughing, wheezing
• Eye swelling, nose blockage and sometimes sneezing
• Flushed face
• Warm feeling throughout body
• Sense of doom
• Dizziness/faintness and potentially collapse
• Anxious, fearful and confused
• Abdominal cramping
• Nausea and vomiting