RCH-style guidance for anaphylaxis in children

RCH commonly refers to the Royal Children’s Hospital. Families in the UAE should follow their child’s own action plan, prescribed device instructions, and local emergency pathway because protocols and available products may differ.

Anaphylaxis is a rapidly developing allergic reaction involving the airway, breathing, or circulation. A child may have noisy or difficult breathing, wheezing, persistent cough, tongue or throat swelling, a hoarse cry, unusual floppiness, pallor, confusion, or collapse. Hives, facial swelling, abdominal pain, or vomiting may accompany these signs, but a rash is not required.

Young children may not describe throat tightness or dizziness clearly. A sudden change in voice, behaviour, alertness, or breathing after food, medicine, or an insect sting can therefore be especially informative.

Give the child’s prescribed adrenaline auto-injector into the outer thigh immediately, through clothing if necessary, and call UAE emergency services. Lay the child flat and do not allow standing or walking. A child struggling to breathe may sit with legs extended; an unconscious breathing child belongs in the recovery position. Hold an infant flat rather than upright against the shoulder.

Follow the written action plan if symptoms persist, including its direction about another injector. Bring used devices, the suspected trigger, medicine packaging, and the action plan to the hospital when practical. Food and drink should wait while breathing or alertness is impaired.

Every child given adrenaline for suspected anaphylaxis needs emergency assessment, even when symptoms improve. Call immediately for breathing difficulty, tongue swelling, voice change, floppiness, faintness, or collapse. Hospital monitoring matters because symptoms can recur after apparent recovery, and clinicians can decide when discharge is safe.

Ask the clinician to confirm the child’s weight-appropriate device, demonstrate its use, and provide a written plan for home, school, and caregivers. Clarify suspected triggers, safe avoidance, device replacement dates, where injectors should be kept, and whether specialist allergy testing is suitable.