food allergy drip

More than 90% of mild to moderate food allergies do not require infusion at all. Only when severe allergic reactions occur (including anaphylactic shock, laryngeal edema, severe generalized rash with fever/electrolyte imbalance, etc.), intravenous infusion is the necessary treatment method. In other cases, oral antihistamines + allergen avoidance options are preferred.

When I was working the night shift last week, I met a little girl who had just entered college. She rushed in with half a box of uneaten mangoes in her hands. Her mouth was swollen like a sausage, and her neck and arms were covered with contiguous wheals. The first thing she said when she entered the door was, "Doctor, I need an intravenous drip. Please arrange it for me quickly. I have to take graduation photos tomorrow." I measured her blood oxygen and blood pressure and it was normal, and there was no tightness in her throat. I directly prescribed 10 mg of loratadine and asked her to sit outside the clinic for half an hour and observe that the condition did not worsen before returning. The little girl was not very happy at the time, saying that her roommate's allergy last time was gone after an infusion of fluids the next day, and she was afraid that taking medicine would delay things. As a result, he specially sent me a selfie the next afternoon. The swelling had completely subsided and the makeup was almost invisible. He also said that if he had known that no infusion would be needed, he would not have to go to the emergency room in the middle of the night.

In fact, there have always been disagreements in clinical circles about whether infusion should be used for food allergies. Most doctors of the old school adhere to the principle of "can take orally without intramuscular injection, can intramuscularly inject without infusion". After all, intravenous infusion is an invasive operation. Even if it is the most common normal saline, there is a very small probability of phlebitis and infusion. For fluid reactions, if antibiotics are given incorrectly, it may aggravate allergic symptoms. The WHO has long mentioned the need to reduce unnecessary infusions. The onset of action of oral antihistamines for mild to moderate allergies is actually only half an hour to one hour slower than infusions, which can fully cover the needs of most cases.

But that doesn’t mean that infusion is necessarily a scourge. I have met many sales patients who had to rush to an important press conference the next day. They were so itchy that they couldn’t even read out their speeches. Oral medicines were still not suppressed after taking oral medicine for most of a day. At this time, it is not impossible to infuse a small dose of glucocorticoids under the doctor’s evaluation to quickly suppress the symptoms. After all, everyone has different needs and priorities. As long as you know the risks in advance and follow the doctor’s advice.

But if you encounter a severe allergic reaction, infusion can be life-saving. Last month, a young man who ate crayfish was transferred to the emergency department. When he came, his face was purple from holding back, and his blood pressure dropped to 80/50. He couldn't even tell the story. At this time, not only did he need infusion to rapidly expand the volume, but he also needed intravenous injection of epinephrine and glucocorticoids. Ten minutes later, his life might be in danger. At this time, don't worry about the side effects of the infusion. The most important thing is to save your life first.

There are also many people who ask for "anti-inflammatory drugs", that is, antibiotics, as soon as they develop allergies. This is really a huge misunderstanding. Food allergy is essentially a type I allergic reaction of the immune system. It is your immunity that treats originally harmless food as a foreign invader and attacks it. It has nothing to do with bacterial infection. Antibiotics are not only useless at all, but may also disrupt your normal flora and make the allergy heal more slowly. I have met several patients who randomly asked for antibiotics and ended up with more and more rashes. I really didn’t know whether to laugh or cry.

In the five or six years I have been working as a dermatologist, less than 10% of the food allergy patients I have encountered actually need infusion. Most people are in a hurry to get infusion, either because they are frightened by the rash all over their body, or because they have the inherent impression that "infusion will make them better quickly". In fact, as long as you don't have symptoms such as dyspnea, palpitation, or dizziness, take oral medicine on time, stop touching foods that make you allergic, and drink more warm water to promote metabolism, you can basically get rid of the symptoms in about 3 days. If you still feel uncomfortable after taking the medicine, or your symptoms are getting worse, it’s not too late to go to the hospital to see a doctor to evaluate whether you need infusion. Just don’t make blind judgments on your own.