Taking the necessary precautions to prevent allergic reactions is no guarantee that a reaction won’t occur. Hidden ingredients, unlabeled foods, and cross contamination are always possible, so remain prepared at all times, carry your medications with you, and remain at the ready to respond in a hurry. If you or a loved one experiences a reaction, despite your best efforts at avoidance, what should you do?

Identify Food Allergy Symptoms - Severe reactions can escalate in a hurry but may begin with more subtle symptoms, such as an itchy mouth, panic, or an impending sense of doom. The earlier you respond to a reaction, the better the outcome, so make sure that you, your friends, and your family can recognize the signs and symptoms:

• Mouth: Itching or swelling of the lips, tongue, or mouth
• Throat: Itching or a sense of tightness in the throat, hoarseness, or a hacking cough
• Skin: Hives, itching, or swelling of the face or extremities
• Gut: Nausea, abdominal cramps, vomiting, or diarrhea
• Lungs: Shortness of breath, repetitive coughing, or wheezing
• Heart: Lightheadedness, fainting
• Anxiety: Panic or sense of impending doom

Each reaction can present different symptoms. If your symptoms typically consist of breaking out in hives, you have no guarantee that your next reaction will begin with hives. You may experience anxiety, nausea, a tightening of the throat, or any of the other symptoms described above.

Tell Someone Immediately - Whether you experience a reaction alone or when accompanied by others, always tell someone else immediately. A common mistake people make, especially in social situations, is to wander off from the crowd and try to attend to the reaction themselves.

They follow their natural impulse to avoid becoming party poopers, or in the case of teens, just look different. The problem with this approach is that a reaction can progress from relatively subtle symptoms to a life-threatening situation in a matter of minutes. You can faint.

Your airway can become restricted to the point at which you can’t talk. At the first sign of a reaction, tell someone. If you’re alone, call 911, a nearby family member, or a neighbor. If you’re on a date, tell your date. If you’re with friends or family members, tell them. Make sure someone stays with you until the crisis is resolved.

Remain As Calm As Possible - Feeling anxious and nervous in the midst of a severe reaction is certainly understandable, and I’m not about to tell you Don’t Panic! I do recommend, however, that you remain as calm as possible.

When people panic, they generally make mistakes and often forget the emergency action plan they carefully reviewed with their doctor. You know what you need to do at this point — take your medications, call 911, and wait for help to arrive. Sometimes taking decisive action can reduce some of the anxiety.

Consider rehearsing your emergency action plan in preparation for a possible future reaction. I know this may sound a little corny, but sometimes if you act it out on your own, your body will “remember” what you need to do, even when your brain is in panic mode.

Respond Immediately - Patients often let a reaction escalate unnecessarily because they question their instincts. They think that some relatively minor symptoms will just go away on their own or that calling 911 is a sign that they’ve officially become drama queens.

Because a severe reaction has the potential to become a lifethreatening reaction, however, an immediate response is critical. The faster you can reverse the overreaction of your immune system, the better the outcome and the faster you’ll start feeling better.

If a friend or loved one is experiencing a reaction, don’t let the person talk you out of administering medication or calling 911. Act immediately. Err on the side of overreacting. You can apologize later . . . if you think you need to.

Administer Medications - Medication is key to successfully thwarting a reaction, and an epinephrine autoinjection is best. If you have an autoinjector, give yourself an injection immediately. If an autoinjector is unavailable and you can swallow, Benedryl is the next best option, and liquid or Fastmelt Benedryl is preferable.

How much Benedryl should you take? Consult your doctor prior to experiencing a reaction to determine an effective, safe dose. Antihistamines have no life-saving properties. If you throat is swelling closed, it will do nothing and is never a substitute for epinephrine.

Call 911 - Whenever you or a loved one experiences a severe reaction, call 911 immediately after administering medication. If you don’t have medication, calling 911 immediately is even more important. When you call, be sure to provide the dispatcher the following information:

• You’re experiencing anaphylaxis.
• You need epinephrine.
• Your current location.

If you’re the one experiencing the reaction, have someone else place the call for you. Some doctors recommend that anyone experiencing anaphylaxis lie down to help alleviate symptoms with low blood pressure. I don’t recommend it for everyone, but if you feel faint or lightheaded, lie down.

Don’t Drive Yourself - Calling 911 and waiting for the EMTs to arrive with epinephrine and additional medical supplies and equipment is usually the best option, but if an emergency room is nearby, having someone drive you to the emergency room is another good option.

Whatever you do, don’t try to drive yourself. If symptoms escalate on your way to the hospital or emergency room, you could have a serious accident or even a minor fender bender that could delay treatment. Ask a friend, family member, or neighbor to drive you.

Call Your Doctor - Your doctor is not the person to call when you’re in the midst of a severe reaction, but after you’ve obtained emergency treatment, call your doctor or allergist and report in. Your doctor may want to see you for a follow-up, provide you with prescriptions for medication refills or new medications.

And offer advice on follow-up treatment in the hours after your initial reaction. As soon as possible after receiving emergency treatment, call your doctor or allergist or have someone call for you. Your doctor should be aware that you’ve experienced a severe reaction.

Call Family or Friends - In some cases, a complete stranger may come to your assistance during a severe reaction, in which case you end up in the emergency room with no way home and nobody to watch over you. Call a friend or family member or have the hospital place a call to let them know what happened and ask them to drive you home and stay with you.

In the hours after a severe reaction, symptoms may recur. You face the greatest risk in the four hours immediately after receiving emergency treatment, during which time, you should remain in the emergency room under observation. Ask a responsible adult to watch over you until the risk of recurring symptoms passes.

Review What Happened - Figuratively speaking, you want to do a post mortem after any reaction, particularly a severe reaction, while that reaction is fresh in your mind. Jot down the following details:

• Where you were when the reaction occurred
• What you were doing when you first experienced symptoms
• What you had eaten just prior to experiencing symptoms
• The amount of time that passed between when you ate the suspect food and when symptoms appeared

Take your notes to your next doctor’s appointment, describe what happened, and discuss possible adjustments to your food avoidance strategies to avoid similar situations in the future.