Allergic Reactions

Anaphylaxis is a severe allergic reaction that involves several parts of the body. Immediate allergic reactions include the development of hives on the face or body; sneezing and watery eyes; coughing; choking; or gagging; wheezing and trouble feeling dizzy or lightheaded, loss of consciousness. Anaphylaxis can be fatal if not treated immediately with epinephrine.

Research studies have shown that a significant proportion of children and parents/caregivers do not always recognize the signs of anaphylaxis. They also get confused about the proper steps for treatment.

Canadian Anaphylaxis Action Plan for Kids (Kids’ CAP)

The Canadian Anaphylaxis Action Plan for Kids (Kids’ CAP) is a tool to educate children and caregivers about anaphylaxis. The main focus of this tool is to answer two questions: 1) How to recognize the symptoms of anaphylaxis; 2) What are the appropriate treatment steps of a child experiencing an anaphylactic reaction.

The action plan document was developed by our research team at CHEO in 2015 and include validated pictograms with written instructions that are easily understood by students at grade 7 and above. We subsequently engaged over 200 children and caregivers to assess the perceived usefulness of the plan, and its educational value. Our research found that the Kids’ CAP is a useful tool for children who are at risk of anaphylaxis. Health professionals are encouraged to use this evidence-based tool, which has been validated in English and French languages, to educate their patients about anaphylaxis.

For more information here is a video in English , as well as one in French.

Research Projects

Canadian Anaphylaxis Network- Predicting Recurrence after Emergency Presentation for Allergic REaction (CAN-PREPARE): A Prospective, Cohort Study Protocol
09/10/2022
Separating Fact from Fiction in the Diagnosis and Management of Food Allergy
19/10/2021

The goal of this commentary is to review important themes that have emerged in our understanding of food allergy management.
The Risk of Allergic Reaction to SARS-CoV-2 Vaccines and Recommended Evaluation and Management: A Systematic Review, Meta-analysis, GRADE Assessment, and International Consensus Approach.
18/06/2021

We recommend further research to clarify SARS-CoV-2 vaccine/vaccine excipient testing utility in individuals potentially allergic to SARS-CoV2 vaccines or their excipients.
The Revenge of Unintended Consequences of Anaphylaxis-Risk Overdiagnosis: How Far We Have Come and How Far We Have to Go
17/06/2021

medicine remains a science of uncertainty and an art of probability, a critical approach to risk mitigation remains necessary to find the often-elusive balance in anaphylaxis prevention.
Skin Testing for Penicillin Allergy: a Review of the Literature
18/03/2021

This review provides support for risk stratification assessment of reported penicillin allergy to optimize antibiotic use and prevent emergence of antimicrobial resistance.
Management of pediatric allergic reaction: Practice patterns of Canadian pediatric emergency physicians
08/09/2020

Most respondents recognized cases of anaphylaxis; however, a substantial number demonstrated gaps in management that may adversely impact this vulnerable population. The recognition of anaphylaxis without urticaria or pulmonary findings and treatment of anaphylaxis with epinephrine, where indicated, were the main gaps identified.
Predictors of future acute asthma visits among children receiving guideline recommended emergency department discharge management
23/04/2020

This retrospective cohort study that shows that even if children receive an asthma action plan or prescription for inhaled steroids after a tertiary care ED asthma visit, youth with a peanut allergy, with high severity symptoms at presentation, and a prior asthma diagnosis are most likely to return to the ED.
The Canadian anaphylaxis action plan for kids: development and validation
02/01/2020

The Kids’ CAP is a useful educational tool to improve patient’s comprehension of anaphylaxis management.
Do Corticosteroids Prevent Biphasic Anaphylaxis?
01/09/2017

Corticosteroids are thought by some to prevent the development of biphasic symptoms and, therefore, commonly used in the emergency treatment of anaphylaxis but this has not been systemtically analyzed.
Epidemiology and clinical predictors of biphasic reactions in children with anaphylaxis
17/06/2015

Biphasic reactions seem to be associated with the severity of the initial anaphylactic reactions. We identified clinical predictors that could ultimately be used to identify patients who would benefit from prolonged ED monitoring and enable better utilization of ED resources.