TOP 8 - Parents’ Perspectives on Pediatric Emergency Department Care After First-Time Food Allergic Reactions in Infants and Toddlers

Publication Number: 2833.TOP 8

Angeliz M. Caro Monroig, UPMC Childrens Hospital of Pittsburgh, Pittsburgh, PA, United States; Ursula Parlin, UPMC Childrens Hospital of Pittsburgh, Pittsburgh, PA, United States; Craig W.. Yarger, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States; Jane K. Soung, UPMC Childrens Hospital of Pittsburgh, Pittsburgh, PA, United States; Christine A. March, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States; Hey Chong, UPMC Childrens Hospital of Pittsburgh, Pittsburgh, PA, United States

Background: Food allergies are a common and potentially life-threatening condition, affecting nearly 8% of children. Recent studies show a rising trend in emergency department (ED) visits for food-induced anaphylaxis, with the highest incidence among infants and toddlers. In this population, accurate and timely diagnosis is particularly challenging due to atypical symptom presentation, limited communication abilities, and overlap with other common conditions. These factors can delay recognition and appropriate medical intervention.

While most of these patients are safely discharged following ED treatment and observation, the quality of discharge counseling is critical to ensure a safe transition home and to prevent recurrent reactions before outpatient follow-up. Parents play a key role in food allergy management; however, their perspectives on ED care and discharge counseling remain largely unexplored. Understanding parental experiences can identify gaps and inform strategies to enhance clinical care and caregiver preparedness for children with food allergies.

Objective: We aimed to explore parent perspectives on the care their child received in the pediatric emergency department (PED) after experiencing a first-time food-induced allergic reaction to identify discharge information and care needs.

Design/Methods: We are conducting a qualitative study using semi-structured interviews. Participants are parents of children under 3 years who received care at a PED for a first-time food allergic reaction. Participants were recruited through ED and allergy clinic rosters using convenience sampling.

We developed and tested an interview guide exploring parent’s experiences with PED care, discharge counseling, and post-discharge needs. We audio-recorded and transcribed 13 telephone interviews between January and October 2025.

Transcripts were reviewed to develop codes and a corresponding codebook. All interviews were coded using NVivo 15 and are undergoing double coding to ensure >80% interrater reliability. Coding discrepancies are resolved through discussion. Based on the coding completed to date, thematic saturation was achieved.

Next steps include conducting a conventional content analysis to identify key themes, followed by theme validation through participant feedback from parents. This study was deemed exempt by our institutional review board.