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Interview with an Emergency Room Physician

“Every three minutes, a food allergy reaction sends someone to the emergency room” (FARE Food Allergy Facts and Stats). Let that thought sink in for a second. Think about how somebody’s life could be quickly disrupted because they ate something they are allergic to. As a kid with food allergies who has had multiple allergic reactions, the feeling of using an EpiPen and going to the emergency room can be terrifying. Today, I will be interviewing an emergency room doctor who has treated many people with allergic reactions. Dr. Neel Kumar, who graduated from medical school at Albert Einstein College of Medicine in 2003, will be answering all of my questions about helping treat food allergies in the emergency room.

GC: Where did you go to medical school, and where did you train? When did you graduate?

Dr. Kumar: I attended medical school at Albert Einstein College of Medicine in New York City. I did my residency at Jacobi and Montefiore Hospitals, also in New York City. I graduated from medical school in 2003 and residency in 2007.

GC: As an ER doctor, how much training do you receive for food allergies?

Dr. Kumar: Allergic reactions are a common cause of a visit to the ER in the United States. Any emergency medicine-trained physician has had a lot of training in managing allergic reactions during residency.

GC: How often do you see people that have anaphylactic reactions?

Dr. Kumar: I see allergic reactions every week and anaphylaxis approximately every 2 months.

GC: What is the protocol when you treat someone with an anaphylactic reaction?

Dr. Kumar: When someone has anaphylaxis, whether it be an adult or child, we establish intravenous access like an IV.  They are then connected to cardiac and respiratory monitors in the ER and given medications to help reverse the immune system process.

GC: What medications do you administer to people who have anaphylactic reactions?

Dr. Kumar: They are given a steroid, an antihistamine such as Benadryl, Pepcid, and also epinephrine if needed.

GC: What are common signs or symptoms you see in a person who has anaphylaxis and comes to the ER?

Dr. Kumar: Signs and symptoms associated with typical anaphylaxis include dermatological changes, such as hives, skin swelling, or flushing. Also, patients may have respiratory symptoms, which include shortness of breath, sensation of closure of throat, wheezing, stridor, and increased respiratory rate. It is important to note that the definition of anaphylaxis includes the involvement of any two organ systems. So frequently this is manifested as a skin change, as I mentioned earlier, and also respiratory symptoms. But less often it can include two other organ systems, like skin and gastrointestinal systems. Gastrointestinal symptoms consist of nausea, vomiting, and abdominal pain. If the anaphylaxis is severe enough that it causes cardiovascular compromise, a drop in blood pressure can lead to lethargy, dizziness, and decreased mentation.

GC: Do you have any recommendations for a patient that comes in with anaphylaxis?

Dr. Kumar: For anyone who comes to the emergency room with an allergic reaction or anaphylaxis, it may feel overwhelming. The symptoms of the allergic reaction can be quite uncomfortable and scary.  In addition, there is typically a flurry of activity and numerous people in the patient’s room, including a physician, one or more nurses, as well as emergency technicians.  Multiple things can be going on simultaneously, such as the patient being attached to cardiac and respiratory monitors, IV lines being established, and medications being administered.  You get a lot of questions from the physician as well. This whole process can be intimidating, and for someone who has not been to the emergency department, it is important to remain as calm as possible and remember that the medical personnel are there to help the patients feel better.

GC: What is your advice to a kid with food allergies?

Dr. Kumar: My advice would be to stress the importance of always carrying your EpiPen, especially for someone who has had a severe allergic reaction or anaphylaxis in the past. In addition to being an ER doctor, I am also the father of two kids with food allergies.  I understand some of the fear and frustration that individuals with food allergies have. I would say, “Take your food allergies seriously but don’t let them limit you. Keep your head up and enjoy every day to its fullest.”

Some key takeaways from this interview would be to always keep your EpiPen with you. As a food allergy patient, I can tell you firsthand that experiencing a reaction is not a pleasant moment. If you ever find yourself in the emergency room as a result of an allergic reaction, remember what Dr. Kumar said, remain calm and give the doctor as much information as possible. 


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