TABLE 3

Treatments Received by Children Who Presented to the ED With a Food-Related Acute Allergic Reaction

Overall (N = 1255), % (95% CI)No Anaphylaxis (N = 597), % % (95% CI)Anaphylaxis (N = 658), % (95% CI)aP
Pre-ED treatments
    Pre-ED treatments (<3 h before triage)61 (56–66)52 (45–60)69 (63–75).001
        Epinephrine40 (34–46)27 (18–36)49 (41–56).001
        Benadryl77 (71–83)74 (64–84)79 (72–85).44
        Other antihistamines7 (4–10)7 (2–12)7 (3–12).88
        Steroids8 (6–10)2 (1–2)12 (9–16)<.001
        Intravenous fluids2 (1–2)1 (0–1)2 (2–3).02
        Inhaled β-agonists13 (10–17)4 (1–7)20 (15–25)<.001
        Oxygen1 (1–2)02 (1–3)<.001
        Other6 (3–10)9 (1–16)5 (1–8).27
    No. of pre-ED epinephrine doses<.001
        076 (72–79)86 (81–91)66 (61–72)
        123 (19–27)14 (9–19)31 (25–36)
        >12 (1–2)03 (2–3)
    Administrator of pre-ED epinephrine
        Patient's own device72 (66–77)86 (79–92)66 (58–74).002
        Emergency medical services14 (10–18)NC16 (11–22)
        Outside hospital10 (7–12)NC11 (8–15)
        Doctor's office/clinic8 (4–12)NCNC
ED treatments
    Oxygen2 (1–3)NC3 (2–5)
    Intravenous line established19 (17–21)7 (5–8)30 (26–34)<.001
        Intravenous fluids given22 (16–28)13 (6–19)23 (17–30).03
    No. of epinephrine doses given in ED<.001
        086 (84–89)93 (89–97)80 (76–84)
        113 (11–16)7 (3–11)19 (15–23)
        >10.3 (0.2–0.4)01 (0.4–1)
    ED antihistamines given60 (55–65)61 (53–68)59 (53–65).73
        Benadryl92 (89–94)99 (98–99)85 (80–90)<.001
        Other H1 blockers1 (0–2)NC2 (0–4).02
        H2 blockers20 (16–24)7 (4–10)33 (26–40)<.001
    ED steroids given<.001
        Prednisone28 (24–33)19 (14–25)37 (31–42)
        Methylprednisolone (Solu-Medrol)10 (8–11)4 (2–6)15 (12–18)
        Other3 (2–4)1 (0.6–1)5 (2–7)
        None59 (54–63)75 (69–82)43 (37–50)
    Inhaled β-agonists given8 (6–9)2 (0.4–3)14 (11–16)<.001
    Inhaled anticholinergics given1 (1–1)NC1 (1–2)
    Additional medications given2 (1–3)NC4 (2–6)
Overall treatments
    Total No. of epinephrine doses given<.001
        064 (59–68)79 (73–85)50 (44–56)
        133 (29–38)21 (15–27)44 (38–50)
        >13 (2–4)06 (4–7)
    Total No. of epinephrine doses given among patients receiving any epinephrine<.001
        192 (90–94)10088 (86–91)
        >18 (6–10)012 (9–14)
  • NC indicates non-calculable; H1, histamine 1; H2, histamine 2.

  • a Anaphylaxis was defined as an allergic reaction involving ≥2 organ systems or hypotension. Hypotension was defined as systolic blood pressure of less than (70 + [age ×2]) for children younger than 10 years and systolic blood pressure of <90 mm Hg for children aged 10 to 18 years.