Thought Archive

Emergencies

First Aid for Severe Allergic Reactions (Anaphylaxis)

30 Aug 2025

First Aid for Severe Allergic Reactions (Anaphylaxis)

Intro

Anaphylaxis is a life-threatening allergic reaction that develops quickly. Early recognition and immediate epinephrine (adrenaline) can save a life. Always seek emergency care after treatment because symptoms can return.

Key Points

  • Give epinephrine first, fast. Don’t wait to see if it improves.
  • Call emergency services immediately after the first dose.
  • Lay the person flat with legs raised; pregnant → left side; breathing trouble → sit up slightly.
  • If no improvement in 5–10 minutes, give a second auto-injector (if available).

Recognize Anaphylaxis (any one of these after exposure to a likely allergen)

  • Breathing problems: noisy breathing, wheeze, throat tightness, hoarse voice.
  • Circulation problems: pale/clammy, faintness, weak pulse, collapse.
  • Skin/gut symptoms plus breathing/circulation signs: widespread hives/flush, swelling of lips/tongue/face, severe tummy cramps/vomiting.
  • Rapid onset minutes to (less commonly) hours after food, stings, meds, latex, etc.

What To Do — Step by Step

  1. Use an epinephrine auto-injector now.
    • Inject into the outer mid-thigh through clothing if needed.
    • Hold in place per device instructions (usually ~3 seconds).
  2. Call emergency services immediately (even if symptoms improve).
  3. Position
    • Lay flat, legs raised.
    • Breathing trouble: semi-reclined (avoid standing/walking).
    • Pregnant: left side.
  4. Second dose if not improving in 5–10 minutes (use a second auto-injector).
  5. Monitor airway & breathing. Be ready to start CPR if needed.
  6. Avoid giving food/drink. Do not rely on antihistamines or inhalers instead of epinephrine.

Aftercare & Observation

  • Must be observed in hospital; biphasic reactions can occur hours later.
  • Record time(s) of injection and device type for clinicians.
  • If stung, scrape off the stinger; apply cold pack for pain/swelling.

Auto-Injector Tips

  • Common brands: EpiPen, Jext, Auvi-Q (device instructions vary—practice with a trainer).
  • Dosage (typical):
    • Children 7.5–25 kg: 0.15 mg
    • ≥25–30 kg and adults: 0.3 mg (some adults may be prescribed 0.5 mg)
      Follow the device prescribed by a clinician.
  • Check expiry dates and store at room temperature (avoid heat/light).

Prevention & Planning

  • Identify triggers (foods, stinging insects, meds, latex).
  • Carry two auto-injectors at all times if prescribed.
  • Wear medical ID; share an action plan with family, school, or workplace.
  • Ask about allergen immunotherapy (e.g., venom) if appropriate.

FAQ

Can antihistamines replace epinephrine?
No. They may help itch/hives but do not treat airway or circulation problems.

What if I’m not sure it’s anaphylaxis?
If in doubt, use epinephrine. The risk of giving it unnecessarily is low; delay is dangerous.

Asthma + food allergy — higher risk?
Yes. Poorly controlled asthma increases risk for severe reactions; ensure asthma is well managed.

Further Reading