Grant: Project Grant

Food allergy impacts 1-in-2 Canadian households, and up to 80% of severe allergic reactions in children are triggered by food. In Canada, approximately every 10 minutes, there is an Emergency Room (ER) visit for food-induced allergic reaction. In the event of an allergic reaction, treatment guidelines recommend that children be transported by an ambulance to an ER for observation, even if symptoms are mild or have stopped. The rationale behind the need for observation in the ER is that some patients are at risk of delayed reactions which can be life-threatening. The delayed allergic reaction consists of a return of symptoms after a period in which patients seem to recover from the first reaction successfully. Unfortunately, research data on the frequency, timing, severity, and predictors of delayed allergic reactions are very limited. As a result, many children are also admitted to the hospital or observed in the ER for long hours to increase the chance of detecting delayed reactions. Canadian families described feelings of ambiguity about the severity of a reaction and hesitance to treat with epinephrine along with perceptions that ER visits often involve a long post-treatment wait time. The unpredictability of reactions and anticipation of ER visits can have a significant psychosocial impact on children and their caregivers. In fact, surveys of Canadian families showed that almost half of respondents described their anxiety level as 8 out of 10 or higher. The main objective of this study is to determine which combination of risk factors identify children with allergic reactions who are at risk of developing delayed reactions. From this knowledge, we can develop appropriate guidelines so that children at high risk are monitored appropriately, whereas those at no or low risk can be discharged from the ER once they became asymptomatic. These guidelines will be highly beneficial to our community and to the healthcare system.