Discharge advice following positive oral food challenge or supervised feed

Discharge advice following positive oral food challenge or supervised feed

Your child has had a ‘positive’ food challenge which means they experienced an allergic reaction to the food that they were challenged to. They should strictly avoid this food.

Your child has been treated with appropriate medications and observed on the ward for at least two hours after their reaction. It is unlikely that your child will develop further reactions; however, rebound reactions can occur very rarely.

Your child should have a restful afternoon where you can continue to observe them. If the reaction has completely settled, your child can go to school and continue with their usual activities the next day.

Very occasionally, ‘late phase’ reactions can occur up to eight hours after the challenge, but this is very unlikely.

Late phase reactions requiring urgent medical attention:
The symptoms would include:

• Difficulty swallowing, talking or have a swollen tongue
• Difficulty in breathing – wheezing, constant coughing, noisy breathing, laboured breathing
• Change in consciousness level – fainting, floppy, unconscious

Dial 999 asking for an ambulance and say ‘Anaphylaxis’.

If your child has these symptoms and you have an Adrenaline Auto Injector, then please administer it and call 999

If your child develops mild/moderate late phase reactions including hives, itchy skin, runny nose, swollen itchy eyes, vomiting, or diarrhoea, then administer a further dose of cetirizine (antihistamine).

Cetirizine doses:
Ages 1-2 – 2.5mg (2.5mls)
Ages 2-6 – 5mg (5mls)
Ages 6+ – 10mg (10mls)

If symptoms are persisting or your child is unwell in other ways, you also have open access to Riverbank Children’s Ward (ground floor of Worcester Royal Hospital) for 24 hours following the food challenge. This means you can speak to a nurse or doctor for an assessment and advice.

Riverbank Ward telephone number is: 01905 760588

Allergy Action Plans and emergency medication

You still need to carry your child’s emergency medication and their Allergy Action Plan. This should have been amended at your challenge. Please get in touch with the allergy team if you have any queries about this.

Information on Adrenaline Auto Injectors (AAI)

If you carry an AAI, training on how to use your AAI should have been completed at your food challenge appointment before discharge. If you would like other family members to be familiar with how to use an AAI, please refer to the company websites:

www.epipen.co.uk
www.jext.co.uk

Both companies also provide free expiry alert services.

Even if your child is prescribed an AAI then they should always have their antihistamine on hand in case of an accidental ingestion to treat mild to moderate reactions.

Allergen Avoidance
Reading food labels and asking the person preparing the food what ingredients they have used is the best way to avoid accidental exposures.

Travelling overseas can make things more difficult. You can buy some specific allergy translation cards from Allergy UK (www.allergyuk.org) and use translation apps on your smart phone to help you. You may also need a letter to take your medicines on the aeroplane.

Allergy Team Contact Information:
Allergy Nurse Mobile: 07564 848463 (please leave a message if there is no answer)
Allergy Team Email: [email protected]
Children’s clinic: 01905 733477

If your symptoms or condition worsens, or if you are concerned about anything, please call your GP, 111, or 999.

Patient Experience
We know that being admitted to hospital can be a difficult and unsettling time for you and your loved ones. If you have any questions or concerns, please do speak with a member of staff on the ward or in the relevant department who will do their best to answer your questions and reassure you. 

Feedback
Feedback is really important and useful to us – it can tell us where we are working well and where improvements can be made. There are lots of ways you can share your experience with us including completing our Friends and Family Test – cards are available and can be posted on all wards, departments and clinics at our hospitals. We value your comments and feedback and thank you for taking the time to share this with us.

Patient Advice and Liaison Service (PALS)
If you have any concerns or questions about your care, we advise you to talk with the nurse in charge or the department manager in the first instance as they are best placed to answer any questions or resolve concerns quickly. If the relevant member of staff is unable to help resolve your concern, you can contact the PALS Team. We offer informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf, if you feel unable to do so, to resolve your problems and where appropriate refer to outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate your concerns. You can make a complaint orally, electronically or in writing and we can advise and guide you through the complaints procedure.

How to contact PALS:
Telephone Patient Services: 0300 123 1732 or via email at: [email protected]

Opening times:
The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please be aware that you may need to leave a voicemail message, but we aim to return your call within one working day.

If you are unable to understand this leaflet, please communicate with a member of staff.

Version 2