{"doi":"10.1016/j.jaip.2024.05.029","title":"Flowsheet Template for the Documentation of Allergic Reactions in Infants and Toddlers","abstract":"A “Practice Pearl” helps an allergist-immunologist practice more safely, effectively, timely, efficiently, equitably, or in a more patient-centered way. This feature is coordinated by Stuart Abramson, MD, Giselle Mosnaim, MD, and Andrew Murphy, MD, from the AAAAI Federation of Regional, State, and Local Allergy, Asthma, and Immunology Societies Assembly and by Editorial Board member Matthew Rank, MD. More information about submitting a “Practice Pearl” can be found on our Web site (jaci-inpractice.org). A “Practice Pearl” helps an allergist-immunologist practice more safely, effectively, timely, efficiently, equitably, or in a more patient-centered way. This feature is coordinated by Stuart Abramson, MD, Giselle Mosnaim, MD, and Andrew Murphy, MD, from the AAAAI Federation of Regional, State, and Local Allergy, Asthma, and Immunology Societies Assembly and by Editorial Board member Matthew Rank, MD. More information about submitting a “Practice Pearl” can be found on our Web site (jaci-inpractice.org). Recognizing and documenting allergic reactions presents a challenge due to the variability in clinical presentations and differences in interpretation among health care providers. Infants and toddlers, being nonverbal, may exhibit distinctive signs and symptoms during allergic reactions and anaphylaxis,1Pistiner M. Mendez-Reyes J.E. Eftekhari S. Carver M. Lieberman J. Wang J. et al.Caregiver reported presentation of severe food-induced allergic reactions in infants and toddlers.J Allergy Clin Immunol Pract. 2021; 9: 311-320.e2Abstract Full Text Full Text PDF PubMed Scopus (19) Google Scholar thereby complicating the diagnostic process. Developing a standardized assessment template tailored for infants and toddlers to document signs and symptoms during allergic reactions provides a practical solution to the aforementioned documentation challenges. In situations where subjective symptoms cannot be verbally described or objectively measured, using a template with specific surrogates tailored to this population facilitates structured documentation. Standardized recording of allergic reaction presentations improves clinical diagnosis and facilitates effective communication necessary to coordinate short- and long-term care. It also assists in the prompt recognition and treatment of anaphylaxis, thereby enhancing performance and quality metrics within a practice or institution. Beyond its clinical significance, the research applications of this tool enable the tracking of reaction severity and response to treatments, including oral immunotherapy or biologics. This enables comparisons of clinical presentations at the time of reaction and allows for longitudinal patient follow-up (Table I).Table IPotential applications of an infant and toddler reaction templateClinical applicationResearch applicationOral food challengesSupport consistent documentation of OFCs and OIT in the clinical settingSupport consistent documentation in clinical trials, OFCs, updosing, etcCan document changes in reaction severity after treatmentEmergency departmentImproved recognition and documentation of anaphylaxis in real time and retrospectively for quality improvementTrack regional and temporal changes in anaphylaxis from an epidemiology perspectivePhone triageImprove documentation and recognition of reactions requiring epinephrine and 911Track adverse reactions from outpatient treatments, ie, medication, biologics, OIT, vaccines, etcPrimary careHelp guide consistent documentation for medical record and help with accurate documentation of potential reactions, ie, medication, vaccines, food, etcAssist in tracking adverse reaction and anaphylaxis in primary care setting, ie, vaccines, supervised feeds, biologics, etcOFC, Oral food challenge; OIT, oral immunotherapy. Open table in a new tab OFC, Oral food challenge; OIT, oral immunotherapy. The template aligns with age-specific literature on severe allergic reactions in infants and toddlers as expressed by primary","journal":"The Journal of Allergy and Clinical Immunology In Practice","year":2024,"id":480970,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9572,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1321097,"name":"Jose Euberto Mendez-Reyes","orcid":null,"position":1,"is_corresponding":false},{"id":425146,"name":"Cynthia A. Esteban","orcid":null,"position":2,"is_corresponding":false},{"id":977699,"name":"Arielle Hazi","orcid":null,"position":3,"is_corresponding":false},{"id":977700,"name":"Mharlove André","orcid":null,"position":4,"is_corresponding":false},{"id":1274496,"name":"Samantha Yap","orcid":null,"position":5,"is_corresponding":false},{"id":254346,"name":"Wayne G. Shreffler","orcid":"0000-0001-6465-137X","position":6,"is_corresponding":false},{"id":423786,"name":"Michael Pistiner","orcid":"0000-0003-2290-6164","position":7,"is_corresponding":false},{"id":159137,"name":"David M. Pyle","orcid":"0000-0002-2663-9940","position":0,"is_corresponding":true}],"reference_count":2,"raw_metadata":null,"created_at":"2026-07-19T02:07:06.225103Z","pmid":"39122335","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}