Fatal reaction to food!!!

Having food allergy, or being the parent of a food allergic child is a bit like being an anesthesiologist or airplane pilot: 99% calm punctuated by 1% sheer terror. Asthma, in contrast, is much more up and down, with less explosive onset of symptoms.

A new study looks at the number and characterisitics of severe reactions to food in pediatric allergic patients. The authors used database searches and letters to pediatricians to try and find every case resulting in admission to the hospital. Any such search is likely to miss some cases, although one would expect they would be the less severe ones.

They divided reactions into fatal, near fatal, severe, and non-severe. The definition of fatal is obvious. Near fatal reactions were those requiring intubation, which is a pretty high standard. Severe reactions met one of the following criteria:
1. Cardiorespiratory arrest (patient stopped breathing, heart stopped beating or both)
2. Need for inotropic support (special meds had to be given to keep blood pressure up or heart beating effectively)
3. Fluid bolus of 20mg/kg or more (usually a sign of hypotension aka low blood pressure)
4. More than one dose of epinephrine
5. More than one treatment with bronchodilator (usually albuterol or salbumatol as they call it in the UK. This indicates ongoing wheezing).
Non-severe reactions were ones that didn't meet the severe criteria.

These criteria are okay, but the definition of "severe" is quite broad. I'd argue that cardiorespiratory arrest is "near fatal" because without intervention they would likely have died.

Near fatal reaction to food