6-year-old boy dies in resuscitation after family dinner with generalized edema

When the boy was brought in, he already had symptoms such as decreased blood pressure and unconsciousness. Although high-flow oxygen and epinephrine injections were immediately arranged, they were accompanied by cardiac arrest, which ultimately failed to save the young life, and all of this came from a family party.

Afterward, the boy's mother took her sister-in-law to court.

Four years ago, it was the 15th day of the eighth month of the lunar calendar, the Mid-Autumn Festival. The boy followed his mother and father back to his grandmother's house in the countryside, a family reunion, very happy.

After lunch, grandpa took the moon cake and called the boy who was playing in the yard to come and eat. The mooncakes were filled with egg yolk and were very tasty. The boy ran over and was just about to eat it when his mother stopped him.

The mother explained that the child was allergic to eggs and dairy products and could not eat them.

Grandpa didn't say anything, but his sister-in-law suddenly stood up: "The children in the past were not so precious, we used to eat everything?"

The boy's mother smiled and did not say anything, after all, the other party is his sister-in-law, and she is not good to refute anything.

The boy ran back to the yard to continue to play, during the boy and the adults in the family said his mouth itched, but the adults were busy playing cards and did not take it seriously.

After another ten minutes had passed, the boy squatted on the ground and said his stomach hurt. The boy's mother came over and thought her son, as usual, just had to go to the bathroom, so she took the boy to the backyard bathroom.

A few minutes passed, and the card game in the front yard was still going on feverishly. The boy's mother suddenly rushed over with her son in her arms in a state of anxiety, only to see that the boy's eyelids were swollen and his body was covered with a dense rash.

The family is panicked, they do not know what is wrong with the child, at this time the boy has begun to convulse and vomit, and his face is not right.

It may be that mother and son are connected, or may have been around their son, the boy's mother's first reaction to her son was that he had food allergies.

Two kilometers away from home is their town's central hospital, and the boy's father immediately decided to drive his son over.

At this point, my sister-in-law came out from nowhere and said, "The conditions of the town health center are not good, my last cold was not good for several days there, it is better to go to the city hospital."

It makes sense, so we held the boy and rushed him to our hospital. Because that day everyone is on holiday, the road is not much traffic, usually need to use 50 minutes of travel, the boy's father used less than half an hour to arrive.

I was on duty that day, and because of the holidays, the normally noisy hospital seemed a little cold. When the nurse came running to call me, I was still thinking about where to take the kids the day after tomorrow when I was off.

When I saw the boy, his face, mouth, lips, and pharynx were all edematous to varying degrees, he was having significant difficulty breathing, his nose was congested and he was confused. On examination, the boy's blood pressure was found to be decreased and croup could be heard in both lungs. I also suspected a food allergy, as his symptoms were probably the most severe form of anaphylaxis in anaphylactic reactions, and there was no time to lose.

To keep the airway open, improve his hypoxic symptoms and ameliorate the symptoms of shock, the boy's head, chest, and lower limbs were then elevated, and monitoring of ECG and oxygen saturation was arranged.

The first step in anaphylaxis resuscitation is to remove the allergen. I asked the boy's family present what he had eaten that he was allergic to, and no one knew.

I arranged for my colleagues to give him high-flow oxygen and remove respiratory secretions. Because it is not easy to find blood vessels in shock patients, usually the best time to apply epinephrine is delayed because of waiting for the suggestion of vascular access, plus epinephrine is the drug of choice for anaphylaxis resuscitation, so it was decided to use epinephrine immediately.

But by the time I was ready to come over in a hurry, the boy had already stopped breathing.

My mom and dad held the boy's cold body, my grandmother collapsed on the floor, my grandfather was flabbergasted, and I held back my emotions not knowing how to tell them that the boy was clinically dead.

A few months later, I heard from the nurse who was involved in the resuscitation at the time that the boy's mother had gotten a lawyer and was ready to sue her sister-in-law.

I was surprised.

"You didn't know that yet? That family later found out that the little boy's allergy was caused by the boy's aunt (the boy's mother's sister-in-law) secretly giving him pure milk."

I felt a chill down my back, and I didn't know what to say about this incident with this person. At that time, after the boy's allergy occurred, the father wanted to take the boy to the town health center, but the boy's aunt said that there is no way, I think there is something fishy about this matter, just no evidence is not good to say anything.

Now with all this, I don't dare to think about it. But these also give us a wake-up call.

First, allergies are not pretentious, they can kill people, especially food allergies.

Because food allergies start quickly, they can easily induce serious allergic reactions and anaphylaxis, but any delay can cause death. If the boy's father had insisted on taking the child to the nearest hospital, the boy would have had great hope of survival, but now it is useless to say anything.

Secondly, there are many more foods that can cause allergies than I thought.

For example, milk and dairy products, eggs, crustaceans (shrimp and crab, etc.), fish, soy, peanuts, nuts, and wheat can all trigger an allergic reaction.

In addition, the golden period for resuscitation of severe food allergy is only half an hour or even a few minutes.

So it is necessary to resuscitate with epinephrine injection before choking or shock occurs. Therefore, it is especially important to identify and diagnose allergies promptly. Parents must not hesitate to take their children to the nearest hospital or call the emergency number immediately after finding or suspecting food allergies in their children, and explain to the doctor the type of food ingested, the amount and time of intake, the presence of other allergic diseases, when the symptoms appeared, etc.!

Finally, some parents cannot tell whether their child has a food allergy or food intolerance, thus delaying the condition.

Here we need to make it clear that food allergies generally have skin mucosal symptoms such as hives, angioedema, and skin itching; gastrointestinal symptoms such as nausea, diarrhea, and abdominal pain; and respiratory symptoms such as laryngeal edema and asthma.

Unlike food intolerances, which generally do not have these symptoms, food intolerances become more uncomfortable the more you eat a certain food, unlike food allergies which are uncomfortable no matter how much you eat.