Whether infected or not, COVID-19 has affected each one of us in some way. As Bob Dylan sang it best “the times they are a-changin’.” Sadly, numerous Americans are still at risk of contracting COVID-19 while treatment options remain inadequate. Complicating the situation, there is an increased risk of contracting the infection with ER visits for unrelated circumstances, e.g. the treatment of severe allergic reactions and anaphylaxis.
In light of such times, the national recommendations for treatment of food allergy reactions and seeking emergency medical treatment have been modified to help limit COVID-19 exposure and ensure our patient’s safety. The original article regarding these modifications can be found at https://www.jaci-inpractice.org/article/S2213-2198(20)30373-1/fulltext and the revised COVID-19 food allergy action plan can be found below. Of course, there will be cases of severe anaphylaxis that will not deviate from the usual plan of calling 911 immediately. In addition, patients and parents should always seek emergency medical services if they believe urgent care is required. We recommend discussing the modified food allergy action plan with one of our providers, and we are pleased to offer clinic visits via phone call or telemedicine for such discussions.
To be clear, our patients should be treated with their Epinephrine auto-injector as soon as symptoms of a severe allergic reaction present. The quicker Epinephrine is administered, the better the chance for a good response. Symptoms to watch for include wheeze, shortness of breath, difficulty breathing, throat/oral swelling, vomiting and faintness. As opposed to previous food allergy action plans, many patients may be monitored for response to Epinephrine treatment prior to calling 911. If the symptoms do not respond to the first Epinephrine treatment, a second dose of Epinephrine should be administered while closely monitoring the person. If the symptoms resolve, their doctor should be notified but emergency medical services may not be needed. This is to help limit COVID-19 exposure. However, if the symptoms do not respond to the second Epinephrine treatment, 911 should be called for emergency medical assistance.
The successful home treatment of anaphylaxis requires a clear action plan and the necessary medications such as Epinephrine. Again, we recommend patients discuss with their doctor what food allergy action plan is best for them.
Home Management of Anaphylaxis Graphic For Use During COVID-19
REVISED FOOD ALLERGY ACTION PLAN
Casale T, et al. Acute at home management of Anaphylaxis during the Covid-19 Pandemic. J Allergy Clin Immunol Pract. 2020.04.022