Recognition, evaluation, and treatment of anaphylaxis in the child care setting

Ann Allergy Asthma Immunol. 2005 Jan;94(1):55-9. doi: 10.1016/S1081-1206(10)61286-0.


Background: Anaphylaxis can occur anywhere. Many young children with a history of allergic reactions or anaphylaxis spend considerable time in child care centers. However, little is known about the centers' knowledge of, experience with, and capability to manage anaphylaxis.

Objective: To evaluate the ability of child care centers to recognize, evaluate, and treat anaphylactic episodes in children aged 1 to 6 years.

Methods: Eighty-five child care centers in the suburbs of Chicago were randomly selected. They were contacted by telephone and asked to participate in a study by completing an initial questionnaire. Center directors and teachers were then offered an allergy seminar addressing anaphylaxis avoidance, recognition, evaluation, and treatment. Center directors completed a questionnaire after the seminar.

Results: Forty-four of the 85 centers contacted agreed to participate. Forty-two surveys were completed before the seminar and 39 after the seminar. On average, each center has up to 7 children with an identifiable food allergy. Information provided by the parents was the most commonly reported source of education concerning allergies. Before seminar completion, only 24% of child care centers would administer intramuscular epinephrine for a severe allergic reaction. After the seminar, 77% of centers stated that they would administer intramuscular epinephrine (P < .001). Also, center staff significantly improved their knowledge of typical allergy symptoms and of the correct method of intramuscular epinephrine administration.

Conclusions: There is a need for greater anaphylaxis education among child care providers. Our intervention significantly increased the ability of child care staff to recognize, evaluate, and treat anaphylaxis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anaphylaxis / drug therapy*
  • Anaphylaxis / etiology
  • Child
  • Child Day Care Centers*
  • Child, Preschool
  • Epinephrine / administration & dosage*
  • Food Hypersensitivity / drug therapy*
  • Humans
  • Infant
  • Injections, Intramuscular
  • Surveys and Questionnaires


  • Epinephrine