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We're going to talk here about foodallergies this is something that youwill run into very frequently if youwork with children and occasionally withadults too one of the big things withfood allergies is patient education andthat cannot be stressed enough becausein a lot of cases with food allergiesit's going to require a change inlifestyle for these patients and fortheir families and so you want to beaware of how to teach these patients andfamilies how they're gonna cope and howthey're going to adjust to their newlifestyle regimen to avoid these foodallergens so that takes that takes adifferent level of knowledge it's onething to be able to know what to do andknow how to manage patients yourself orto teach other physicians or to teachmedical students it's a totallydifferent thing to understand how toteach patients how to take care ofthings and in addition to that thesepatients are also going to need to teachother family members and they're goingto need to teach in some cases teachersand coaches who might not be used todealing with this because this typicallyhappens in children with food allergiesit's more prevalent in children thesechildren are going to be at schoolthey're going to be at daycare they'regonna be at church group what-have-youand the parent is going to need to teachthe babysitter or the coach and so it'simportant that you teach the parent andthat the parent has a really goodunderstanding of all of this so thatthey can go on and make sure thatthey're informing all the individualsthat need to be aware of this becausereally anybody with extended contactwith the child needs to be alerted andaware of how toin an emergency how to manage a anallergic crisis so patient educationfeatures very prominently here and soyou want to be aware not only how youmanage food allergies and acute allergicreactions but also how to teach patientsto deal with it on their own because ina lot of cases if it's a severe enoughallergic reaction they're not going tobe able to get to the hospital soonenough all right so here is our vignettea five-year-old girl is rushed to theIDI by her father because of a suddenrash dad is very concerned and says thatshe has been well up until now andnothing like this has ever happenedbefore she's stable but an obvious rashis visible on her face and arms whichshe is itching at I'm talking to dad hesays that he is not aware of any foodallergies he denies any other symptomsincluding fever vomiting she is notpresently on any medications she is shehas no significant medical history bloodpressure is 100 over 60heart rate 100 persons 22 temperaturenames 4.9 physical reveals multiplesoftware is there are some of thislesions or her face arms and torso noother type of rash is appreciated lipstongue and oral mucosa appear normalthere is no swelling of the hands orfeet lungs are clear to auscultationabdomens non-tender not descended innormal bowel sounds so obviously this isa child with acute urticaria we knowthat based on the pattern of the...
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