Severe Allergic Reactions in Children — What Every Family Needs to Know About Emergency Response

When a child has a severe allergic reaction, the actions taken in the first few minutes matter more than anything done at the hospital. Learn how to recognize anaphylaxis, use epinephrine nasal spray or auto-injectors, and prepare an emergency action plan.

In the past, many parents assumed that allergies simply meant red rashes, itching all over, or stomachaches and diarrhea. For more troublesome symptoms like swollen eyelids or swollen lips, taking antihistamines usually led to gradual recovery.

But in reality, severe allergic reactions, though uncommon, can deteriorate rapidly within minutes:

One moment the child is talking and laughing, and suddenly their voice becomes hoarse and they struggle to breathe.

One moment the child is happily eating, and suddenly they vomit everywhere, turn pale, or even faint and go into shock.

More importantly, when facing such a dangerous and urgent situation, what truly determines the outcome is often not the measures taken after arriving at the hospital, but the actions taken in those first few minutes after the reaction begins.

In recent years, more and more parents have learned that once a severe allergic reaction occurs, epinephrine is the most important emergency medication. But in reality there is a challenge — epinephrine auto-injectors (commonly called “EpiPens”) are very difficult to obtain in mainland China, with significant limitations in accessibility.

Recently, this “dilemma” has seen an important change — China’s first non-injection epinephrine nasal spray has been approved for market. For children weighing ≥30 kg and adults, there is now a more convenient and easy-to-use pre-hospital emergency option.

It has lowered the psychological barrier and operational threshold that some parents, teachers, and caregivers have regarding injections, but it has not changed the emergency bottom line — when a severe allergic reaction is suspected, epinephrine should be used as early as possible, and emergency services should be called immediately; a second dose should also be prepared in advance, rather than pinning hopes on a single dose.