Key Takeaways
Many kids are spending needless hours under hospital observation following an allergic reactionAbout 17% of kids are admitted for overnight observationBut 95% could be safely discharged within two hours of treatment
FRIDAY, June 27, 2025 (HealthDay News) 鈥 Many kids are spending a lot of unnecessary time under observation in a hospital following a sudden allergic emergency, a new study concludes.
About 17% of kids are admitted for overnight observation following a scary allergic reaction to food, medicine or insect bites, researchers reported.
But 95% of children treated for allergic reactions can be safely discharged within two hours after receiving a dose of epinephrine, according to results published in The Lancet: Child and Adolescent Health.
That number rises to 98% if doctors err on the side of caution and keep kids under observation for four hours, researchers found.
鈥淔or most patients, we are probably observing them too long,鈥 said researcher Dr. Kenneth Michelson, a pediatric emergency specialist at Ann & Robert H. Lurie Children鈥檚 Hospital of Chicago.
鈥淭his might sound minor, but if you brought your toddler in for a scary allergic reaction, it’s the difference between going home at 11 p.m. versus going home at 1 a.m. or 3 a.m.,鈥 he said in a news release. 鈥淥ur finding gives us more confidence that after a couple of hours, if symptoms are improving in specific ways, we can probably send the child home.鈥
Most kids who鈥檇 had an allergic reaction can be routinely treated with an epinephrine jab and sent home, researchers said in background notes.
However, about 5% experience a 鈥渂iphasic reaction,鈥 meaning their symptoms can return despite that first dose of epinephrine, researchers said.
For this study, researchers gathered data from more than 5,600 ER visits at 31 hospitals in the U.S. and Canada where allergic reactions were treated with an epinephrine injection.
About 90% of the kids had experienced an allergic reaction to foods like peanuts, eggs, milk, shellfish, sesame, gluten or soy, researchers said. Another 6% reacted to medication and 3% to insect stings.
Only about 5% of the kids needed a second dose of epinephrine within two hours of their initial injection, researchers found. Likewise, only 2% needed the second jab after four hours.
Most kids admitted to hospital beds never needed a second epinephrine shot or intensive care, the study concluded.
This means these kids and their parents are undergoing additional hassle for no real benefit, researchers said.
鈥淲e have seen patients and their families avoid or delay going to the emergency department because they didn鈥檛 want to sit there for hours of observation,鈥 researcher Dr. Hugh Sampson, an allergist at Icahn School of Medicine at Mount Sinai in New York City, said in a news release. 鈥淪uch delays can prove dangerous. This study鈥檚 findings support discharging patients more expeditiously, which will likely reduce patient reluctance to seek necessary help.鈥
Holding kids needlessly also ties up crucial hospital resources, the team added.
鈥淧ediatric emergency departments can get crowded quite quickly, especially during winter infection season. We need to ensure efficient throughput to allow us to provide access to as many patients as we can,鈥 senior researcher Dr. David Schnadower, director of emergency medicine at Cincinnati Children鈥檚, said in a news release.
鈥淎n important value of this study is that it was large enough that the results can give clinicians confidence that discharging patients showing no concerning symptoms in less than two hours is going to be safe for most children,鈥 he added.
More information
Johns Hopkins Medicine has more on allergic reactions in children.
SOURCE: Ann & Robert H. Lurie Children鈥檚 Hospital of Chicago, news release, June 13, 2025
What This Means For You
Based on new findings, doctors should stop holding children for observation following an allergic reaction unless there are other potential health problems.