For the group.
In mild to moderate anaphylaxis with administration of Epi Pen at home
How long is the observation period?
An example case includes a 6 y/o telling his mother that he feels itchy and feels tightness in his throat and chest after eating a dinner prepared at home (nut-free presumably), and develops a hive on his forehead. He has previously been admitted for anaphylaxis to nuts. The mother appropriately administered the EpiPen, Benadryl and came to the ED. Upon arrival,the child was completely asymptomatic.
If the patient is well, remains asymptomatic (no hives, pruritis, swelling, wheeze, etc) and playing in the ED -- how long would you watch them, particularly after receiving an EpiPen injection (you gave steroids and H2 blocker and he already received Benadryl)?
Do you monitor for 2, 4, 6, 8 hrs?
Do you admit because of his anaphylactic history or since he has a food allergy?
Is there any census or literature regarding length of observation after the acute phase reaction; or after Epinephrine administration?
Thank you for your response
Cesar A Arias MD
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