Corn Allergy Emergency Room Safety Doc, Text Only Version

Here’s a text only version of my ER Safety Sheet for people trying to access from mobile phones while in the ER:

Severe allergic reactions to  corn and corn products, especially corn-derived sugars, starches, and alcohols. (see References at end of document)

Intubation

Rinse all tubes to remove corn starch before inserting.

Injected Medications

  • SALINE IV ONLY

  • NO: lactated ringers.

  • NO: dextrose solutions.

  • YES: diphenhydramine hydrochloride injection – Check inactive  ingredients against list below.

  • YES: ranitidine hydrochloride injection- Check inactive  ingredients against list below.

  • YES: Rocephin injection WITHOUT dextrose.

  • YES: SOLU-MEDROL- methylprednisolone sodium succinate injection, powder, for solution”  *preservative free*. No lactose, no benzyl alcohol.

Inhaled Medications

  • YES: Xopenex or other albuterol-only nebulizer.

  • NO: ethanol propellants or inactive ingredients from the list at end of document.


Oral Medications

Check inactive ingredients of all injections and oral medications and cross-reference with ingredient list at end of document. ESPECIALLY avoid:

  • dextrose

  • sucrose

  • glucose

  • sorbitol

  • glycerin

  • polysorbate

  • ethanol/alcohol

  • corn starch

  • modified food starch

  • pregelatinized starch

  • citric acid

  • xanthan gum

  • maltodextrin

Blood Products/Transfusions

Check inactive ingredients/anticoagulants. Many are corn-derived. Please discuss with patient or an advocate if possible before using blood products. If a transfusion is absolutely necessary and the patient does not have other documentation refusing blood products, take necessary measures to prepare for allergic reactions when the products are used.


Wound treatment and disinfecting

  • Disinfectants: Use only saline or betadine solution that contains only water, povidone iodine, and sodium hydroxide. Betadine solution from Purdue products is one safe product. Isopropyl alcohol may also be used where appropriate. No products containing citric acid, glycerin, Pareth alcohols, or ethanol!

  • Sutures: NO DISSOLVABLE SUTURES. Use only non-dissolvable nylon or polypropylene sutures. Rinse to remove corn starch.

  • Local anesthetic: Use only carbocaine or preservative-free lidocaine. No inactive ingredients other than water and sodium chloride!

  • Wound dressing: Use cotton gauze and kerlix or coban tape. No adhesive bandages or steri-strips.

General Care

  • NO hand sanitizer. Medical staff must wash hands and wear powder-free nitrile gloves when touching patient.

  • NO paper gowns or bedding. Cloth gowns and bedding only. No disposable paper pads, gowns, or bed covers. If possible, please allow patient to wear own clothes and allow family to provide linens.

  • NO powdered rubber instruments.  Use metal or glass only.

  • NO disposable thermometers or covers. Only use glass or metal thermometers. If thermometers have been disinfected with alcohol rinse in water first.

  • Do not touch disposable products to face eyes or mouth. Paper, cotton, wood, or disposable plastic should NOT be touched to mucus

References

Possibility of allergic reactions to corn-derived sugars:

http://www.ncbi.nlm.nih.gov/pubmed/1808842- “Probable anaphylactic reaction to corn-derived dextrose solution.”

Possibility of allergic reactions to corn starch:

http://europepmc.org/abstract/MED/1696439/–  Annals of Allergy: “Anaphylaxis due to cornstarch surgical glove powder.”

Possiblity of allergic reactions to corn-based alcohol: http://www.karger.com/Article/Abstract/24107– International Archives of Allergy & Immunology: “Corn Allergens: IgE Antibody Reactivity and Cross–Reactivity with Rice, Soy, and Peanut”  (Abstract states that corn proteins are soluble in alcohol.)

Allergen Ingredients To Be Avoided

  • Acetic acid
  • Alcohol
  • Alpha tocopherol
  • Artificial flavorings
  • Artificial sweeteners
  • Ascorbates
  • Ascorbic acid
  • Aspartame (Artificial sweetener)
  • Astaxanthin
  • Baking powder
  • Barley malt* (generally OK, but can be contaminated)
  • Bleached flour*
  • Blended sugar (sugaridextrose)
  • Brown sugar* (generally OK if no caramel color)
  • Calcium citrate
  • Calcium fumarate
  • Calcium gluconate
  • Calcium lactate
  • Calcium magnesium acetate (CMA)
  • Calcium stearate
  • Calcium stearoyl lactylate
  • Caramel and caramel color
  • Carbonmethylcellulose sodium
  • Cellulose microcrystalline
  • Cellulose, methyl
  • Cellulose, powdered
  • Cetearyl glucoside
  • Choline chloride
  • Citric acid*
  • Citrus cloud emulsion (CCS)
  • Coco glycerides (cocoglycerides)
  • Confectioners sugar
  • Corn alcohol, corn gluten
  • Corn extract
  • Corn flour
  • Corn oil, corn oil margarine
  • Corn starch
  • Corn sweetener, corn sugar
  • Corn syrup, corn syrup solids
  • Corn, popcorn, cornmeal
  • Cornstarch, cornflour
  • Crosscarmellose sodium
  • Crystalline dextrose
  • Crystalline fructose
  • Cyclodextrin
  • DATUM (a dough conditioner)
  • Decyl glucoside
  • Decyl polyglucose
  • Dextrin
  • Dextrose (also found in IV solutions)
  • Dextrose anything (such as monohydrate or anhydrous)
  • d-Gluconic acid
  • Distilled white vinegar
  • Drying agent
  • Erythorbic acid
  • Ethanol
  • Ethocel 20
  • Ethylcellulose
  • Ethylene
  • Ethyl acetate
  • Ethyl alcohol
  • Erythritol
  • Ethyl lactate
  • Ethyl maltol
  • Fibersol-2
  • Flavorings*
  • Food starch
  • Fructose*
  • Fruit juice concentrate*
  • Fumaric acid
  • Germ/germ meal
  • Gluconate
  • Gluconic acid
  • Glucono delta-lactone
  • Gluconolactone
  • Glucosamine
  • Glucose*
  • Glucose syrup* (also found in IV solutions)
  • Glutamate
  • Gluten
  • Gluten feed/meal
  • Glycerides
  • Glycerin*
  • Glycerol
  • Golden syrup
  • Grits
  • High fructose corn syrup
  • Hominy
  • Honey*
  • Hydrolyzed corn
  • Hydrolyzed corn protein
  • Hydrolyzed vegetable protein
  • Hydroxypropyl methylcellulose
  • Hydroxypropyl methylcellulose pthalate (HPMCP)
  • Inositol
  • Invert syrup or sugar
  • Iodized salt
  • Lactate
  • Lactic acid*
  • Lauryl glucoside
  • Lecithin
  • Linoleic acid
  • Lysine
  • Magnesium citrate
  • Magnesium fumarate
  • Magnesium stearate
  • Maize
  • Malic acid
  • Malonic acid
  • Malt syrup from corn
  • Malt, malt extract
  • Maltitol
  • Maltodextrin
  • Maltol
  • Maltose
  • Mannitol
  • Methyl gluceth
  • Methyl glucose
  • Methyl glucoside
  • Methylcellulose
  • Microcrystaline cellulose
  • Modified cellulose gum
  • Modified corn starch
  • Modified food starch
  • Molasses* (corn syrup may be present; know your product)
  • Mono- and di- glycerides
  • Monosodium glutamate
  • MSG
  • Natural flavorings*
  • Olestra/Olean
  • Pareths – e.g. Pareth 25-9
  • Polenta
  • Polydextrose
  • Polylactic acid (PLA)
  • Polysorbates* (e.g. Polysorbate 80)
  • Polyvinyl acetate
  • Potassium citrate
  • Potassium fumarate
  • Potassium gluconate
  • Powdered sugar
  • Pregelatinized starch
  • Propionic acid
  • Propylene glycol*
  • Propylene glycol monostearate*
  • Saccharin
  • Salt (iodized salt)
  • Semolina (unless from wheat)
  • Simethicone
  • Sodium carboxymethylcelluloseSodium citrate
  • Sodium erythorbate
  • Sodium fumarate
  • Sodium lactate
  • Sodium starch glycolate
  • Sodium stearoyl fumarate
  • Sorbate
  • Sorbic acid
  • Sorbitan* (anything)
  • Sorbitol
  • Sorghum* (not all is bad; the syrup and/or grain CAN be mixed with corn)
  • Splenda (Artificial sweetener)
  • Starch (any kind that’s not specified)
  • Stearic acid
  • Stearoyls
  • Sucralose (Artificial sweetener)
  • Sucrose
  • Sugar* (not identified as cane or beet)
  • Threonine
  • Tocopherol (vitamin E)
  • Treacle (aka golden syrup)
  • Triethyl citrate
  • Unmodified starch
  • Vanilla, natural flavoring
  • Vanilla, pure or extract
  • Vanillin
  • Vegetable anything that’s not specific*
  • Vinegar, distilled white
  • Vinyl acetate
  • Vitamin C* and Vitamin E*
  • Vitamins*
  • Xanthan gum
  • Xylitol
  • Yeast*
  • Zea mays
  • Zein

23 thoughts on “Corn Allergy Emergency Room Safety Doc, Text Only Version

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  4. I have a question…
    Are the ranitidine and rocephin both medications that you have had and done ok with? I’m just wondering why you put these particular ones on the list. Do you know if there are others that would be options as well?

    • Thanks for asking these questions. As I state on the disclaimer along the right hand side of the site, I’m not a medical professional and am just sharing the results of my research and the information I am using for myself. I always want people using critical thinking and doing their own research when making decisions about their health!

      Injections of ranitidine (zantac, an H2 blocker) and diphenhydramine (benadryl) are the standard ER response to an allergic reaction. For details on why see the end of my post on treating allergic reactions. I have had both, and they at least helped more than they hurt. Hard to say if they also increased my reaction mildly before helping as by the time I had them I was already reacting badly enough to be in the ER. Both of those drugs are on the list because they, or equivalents, are more or less required to treat reactions. I also take these drugs in compounded capsule form to treat reactions at home, and I know that I do fine with the drugs themselves so long as they don’t come with corny fillers or preservatives.

      The inactive ingredients for all the varieties of injectable ranitidine and diphenhydramine injection I was able to find on DailyMed look relatively corn free. The “check inactive ingredients” phrase is there in case they happen to have the one random injectable variety that is full of glucose or something.

      There’s no common alternative to diphenhydramine (benadryl), but I *have* heard of famotidine (pepcid) being administered as the H2 blocker instead of ranitidine (zantac) before. However when I looked it up on DailyMed, the first injection I clicked on was chock full of corn. So probably ranitidine is a better bet.

      Rocephin is an antibiotic, and I haven’t personally had oral OR injected antibiotics in years, thank goodness. When I cleaned my diet up 7 years ago I suddenly stopped getting chronic respiratory and sinus infections. Imagine that. Anyway, Rocephin in particular is on the list due to a number of moms on the Facebook Corn Allergy Group stating that they’ve used it successfully with their kiddos. There are probably many other antibiotic alternatives that could be fine as well. But if you are in a situation where you need a shot RIGHT NOW, that is a name to suggest.

      Something important to note about the Rocephin injection is that it is very painful, and is usually combined with a topical numbing injection such as lidocaine. Lidocaine *can* be corny, or not, just depending on what the hospital stocks. You just have to check the package insert every time.

      • Thanks! I have had diphenhydramine injections in the ambulance and the ER. Like you said, it’s hard for me to say how truly safe they were due to the fact that I was already reacting but they did seem to help.
        It’s good to know when certain things work for other people but i also try to do as much research as I can. I always feel like we have to be just as knowledgeable, if not more so, than the medical professionals in order to really be able to advocate for ourselves. So the more info I can gather, the better!

        An emergency plan is something that is long overdue for me.
        I appreciate all the the work you have done here. It has given me a really good place to start. Thanks again!

      • No problem. I’m happy that you are doing this kind of thinking instead of just taking my word for it!

        Not sure if you’ve seen my main “ER safety” post, but I have a google doc linked from it that you can save a copy of and use as a template to make your own personalized ER doc. My personalized one has my penicillin and sulfa allergy, and has a lot of the “contact” reaction warnings removed because I don’t react to contact as much and don’t want to clutter the page with uneccesary information.

        https://cornallergygirl.com/2013/04/18/er-safety-emergency-medical-treatment-with-a-corn-allergy/

  5. Do you have any additional information on Lactated Ringer’s solution? I was recently in the hospital and was administered this without any noticeable reaction. My sensitivity is much less than others on the Delphi Avoiding Corn Forum, though. I can tolerate medications with corn derivatives, though with a previous surgery I noted feeling awful from head to toe as I was given a Dextrose IV solution. I thought I had done pretty well until I read this resource. Many thanks for posting this.

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  8. Thank you so much for this whole
    site! I’ve never concerned myself with a corn allergy until my daughter, now 2, came along. Avoiding corn has been the toughest challenge in my life. This helps!

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  10. High Corn allergy girl! Your blog is a lifesaver. I am interested in the article about the possibility of allergic reactions to Corn derived alcohol. The link does not work. Can you give me some guidance as to how I can find it?

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