Allergies are a serious issue for many parents. According to Food Allergy Research and Education (FARE), 32 million Americans have food allergies, and 5.6 of those are children under age 18. Movies and television have given us a dramatic impression of what to expect when someone has a severe allergic reaction. Anaphylaxis doesn’t always look like it does in the movies, though.

Julie Ferrier Berghaus shared an experience she and her daughter had during a controlled challenge at her allergist. Food challenges are a method for precisely diagnosing food allergies, according to FARE. Here’s how it started:

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Berghaus shares that the experience wasn’t what she expected. Her daughter was fed what most would consider a very small portion of food: 1/10 of a cashew. At first, her ears were itchy, which doesn’t seem particularly worrisome. And then:

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One epi shot, oral Zyrtec, and a shot of prednisolone later, and she didn’t seem to be in particularly bad shape. Still, they called the nurse to check on their daughter.

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In just moments, their daughter went from playing to blacking out. Fortunately, medical staff acted quickly and treated her severe reaction. Berghaus goes on to discuss how different it was from what she expected and the importance of giving an EpiPen right away, even if you’re not 100% sure it’s an allergic reaction.

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To sum up: give an EpiPen, even if the one you have is expired, and don’t be afraid to give a second EpiPen. Call 911 as there can be a second reaction. Take allergies seriously; even a tiny amount can cause shock.

Berghaus also included a picture of her daughter going through the experience:

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Always err on the side of caution, and take allergies seriously. You could save a life.