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Letter
Management of anaphylaxis in children undergoing oral food challenges in an adapted COVID-19 field hospital
  1. Ali Al Saleemi1,2,
  2. Linda Farren2,
  3. Kevin F McCarthy2,
  4. Jonathan Hourihane2,3,
  5. Aideen M Byrne2,4,
  6. Juan Trujillo5,6,
  7. Cathryn O’Carroll2,
  8. Mohammed Tariq7,
  9. John J Fitzsimons2,
  10. David Coghlan2,4
  1. 1 Department of Paediatric, Qassim University College of Medicine, Buraidah, Saudi Arabia
  2. 2 Children’s Health Ireland, Dublin, Ireland
  3. 3 Department of Allergy, Royal College of Surgeons in Ireland, Dublin, Ireland
  4. 4 Trinity College Dublin, Dublin, Ireland
  5. 5 Cork University Hospital, Cork, Ireland
  6. 6 University College Cork, Cork, Ireland
  7. 7 Midlands Regional Hospital, Portlaoise, Ireland
  1. Correspondence to Professor David Coghlan, Trinity College Dublin, Dublin 2, Ireland; David.Coghlan{at}tuh.ie

https://doi.org/10.1136/archdischild-2021-322920

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    The COVID-19 pandemic has led to severe disruption of healthcare systems and elective planned care.1 While pandemics are infrequent, the disruption of elective care by acute respiratory viral infections is an annual occurrence, including administration of oral food challenges (OFCs) to children with suspected allergy. A major barrier to performing OFCs outside tertiary centres is the risk of adverse events including anaphylaxis.2 3 We recently reported a large series of food challenges in a COVID-19 stepdown facility,4 and here we describe our process of managing anaphylaxis in this setting.

    Five regional paediatric allergy clinics across Ireland jointly used a vacant COVID-19 field hospital over 6 weeks. OFCs were performed within a pod system, with each pod containing up to six patients (figure 1). Resuscitation protocols and equipment trolleys were identical to those in hospital. For anticipated anaphylaxis events, patient journey was mapped …

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    Footnotes

    • Twitter @DrDaveCoghlan

    • Contributors This letter was designed, directed and coordinated by AAS, DC and KFM. As principal investigator, DC provided overall supervision and contributed to designing, supervising and correcting the manuscript. LF, KFM and AAS designed the methods of the study and related figures. JH and AMB developed the theory and contributed to planning and implementation of the letter. AAS, AMB and JT contributed to the analysis and interpretation of the results. AAS, JJF and CO’C contributed to drafting and revising the manuscript.

    • Funding This project received funding from the National Treatment Purchase Fund.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.