MedicAlert indicating your allergies. Wipe down the seat to help prevent contact reactions or inadvertent skin contact with food particles or spills. Eating food off a contaminated surface area could lead to accidental ingestion of allergens through contamination. Never eat airline food; pack your own food. However, you may want to check with the airline to see if there are any restrictions as to which types of food you are allowed to bring on board or to your destination.
Always keep your adrenaline with you; do not store in the overhead bin. Consider informing passengers sitting in your area about your food allergy.
Keep in mind, however, that the airline will probably not make an announcement to the other passengers, and that passengers can eat food they have brought onto the aircraft. Always be courteous and polite with the flight crew. They are there to help you and we need to help educate them without making unrealistic or unnecessary demands.
Two children's medical records were incomplete. In this series, food allergy was the predominant cause of severe allergic reaction for children.
Food challenges were performed in 2 cases with positive results. Peanut and shellfish allergy were almost equally represented. One atopic patient was suspected having exercise induced anaphylaxis. He had consumed wheat noodles prior exercise.
He had strong skin test reaction to dust mite, peanut and wheat allergen extract. He was pending for food and exercise challenge.
At the time of analysis, with a median duration of follow up 24 months, none of the subjects had actual self-use of the adrenaline auto-injector device in the community. Despite of avoidance measures, 2 out 15 patients had reported inadvertent reaction to allergen food while dined out, both suspected of peanuts and one necessitated emergency room attendance.
Six risk factors, which can be considered in evaluating the risk of a life-threatening reaction, are as follows: 1 Age over 5 years; 2 A history of respiratory tract involvement with the initial or subsequent reactions; 3 A history of asthma requiring prophylactic medication; 4 Peanut or tree nut sensitivity; 5 Reactions induced by trace or small amounts of allergen; 6 A strongly positive skin prick test.
The estimated dispensing rate of 0. Shown in a recent Manitoba, Canada study, 0. Placing the burden of decision making on individuals without medical training may not be appropriate.
Judgement at anaphylactic emergency may be clouded by panic and denial. Therefore the instruction has to be consistent and simple. In the first-aid treatment of anaphylaxis in the community, there is no question that intramuscular adrenaline injection is the treatment of choice.
When in doubt, administer adrenaline. After using it, patients must be transported to an emergency facility for further evaluation. Under-utilisation of adrenaline is probably common. The latter auto-injector is used for adults, and recommended for children weighing 15 kg or more. The dosage for children is 0.
It translates into a shorter valid period of average months and hence a higher cost to patients. It is part and parcel related to our low usage. More importantly, we are at low priority in terms of marketing perspectives. If, however, the only auto-injector available is an outdated one, it could be used as long as no discoloration or precipitates are apparent because the potential benefit of using it is greater than the potential risk of a suboptimal adrenaline dose or of no epinephrine treatment at all, according to the only one study.
Now a trainer pen is available, which entails all the details of actual administration, except no piercing needle. Such dummy devices can be practiced for unlimited times by caregivers, families and school staffs involved in the care of at-risk children. It gives them a feeling of actual firing.
Provision for adrenaline auto-injectors is only part of the management and should not be viewed in isolation. The management should also include education to relevant care-takers on allergen avoidance, food labeling and the appropriate adrenaline usage.
Regular review of action plan and retraining on use of injectors are essential. According to an investigator-designed, validated survey instrument that was self-administered by members of the World Allergy Organization House of Delegates for to , widespread availability in Europe, United States, Canada, and Australia contrasted with limited availability in Asia, South America, and Africa.
This study raises concerns about lack of availability and affordability of adrenaline auto-injectors worldwide for individuals of all ages. A few allergy specialists in private sector could provide it. Adrenaline auto-injector is not a drug item enlisted under 'safety net' for poor. At times, syringe and ampoule of adrenaline was provided instead of auto-injectors which may pose difficulties for untrained people to administer correctly in emergency situation.
The newly founded Hong Kong Society for Paediatric Immunology and Infectious Disease could be the ideal arena for debating the related issues. Instead of going through labour intensive literature review by local experts, we can adopt guidelines which are developed based on critical review of the current best evidence, with due consideration of local health care systems and disease prevalence.
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