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Signs and symptoms of an allergic reaction to monitor for during an oral food challenge

Signs and symptoms of an allergic reaction to monitor for during an oral food challenge
Skin
Feeling of warmth, flushing (erythema), itching (may begin on palms and soles), urticaria, angioedema, morbilliform rash, and "hair standing on end" (piloerection)
Infants and children - Eczematous flare
Oral
Itching or tingling of lips, tongue, or palate
Edema of lips, tongue, uvula, metallic taste
Infants - Drooling
Children - Rubbing tongue against pruritic palate, scratching tongue with hand
Gastrointestinal
Nausea, abdominal pain (colic, cramps), vomiting (large amounts of "stringy" mucus), and diarrhea
Difficulty swallowing*
Respiratory
Laryngeal - Pruritus and "tightness" in the throat, dysphagia, dysphonia and hoarseness, and sensation of itching in the external auditory canals
Lung - Shortness of breath, dyspnea, chest tightness, deep or repetitive cough, and wheezing
Nose - Itching, congestion, rhinorrhea, and sneezing
Cardiovascular
Feeling of faintness or dizziness; syncope, chest pain, palpitations, and/or hypotension (tunnel vision, difficulty hearing)
Neurologic
Anxiety, apprehension, sense of impending doom, seizures, confusion
Infants - Lethargy, hypotonia
Children - Abrupt cessation of activity, fetal position
Ocular
Periorbital itching, erythema and edema, tearing, and conjunctival erythema
Other
Lower back pain due to uterine cramping in women
Children - Ear pulling as an indication of pruritus
Vital signs/other objective measures
Pulse oximetry, respiratory rate, peak flow, pulmonary function testing
Pulse, blood pressure
* Often occurs in association with throat tightness and other upper airway symptoms.
Graphic 77080 Version 4.0