What do you do if you suspect anaphylaxis?
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• If unconscious or pregnant, place in recovery position - on left side if pregnant, as shown below
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• If breathing is difficult allow them to sit with legs outstretched • Hold young children flat, not upright If unconscious, place in recovery position
2 GIVE ADRENALINE INJECTOR 3 Phone ambulance - 000 (AU) or 111 (NZ) 4 Phone family/emergency contact 5 Further adrenaline may be given if no response after 5 minutes 6 Transfer person to hospital for at least 4 hours of observation IF IN DOUBT GIVE ADRENALINE INJECTOR ALWAYS give adrenaline injector FIRST, if someone has SEVERE AND SUDDEN BREATHING DIFFICULTY (including wheeze, persistent cough or hoarse voice), even if there are no skin symptoms. THEN SEEK MEDICAL HELP. Adrenaline injectors are given as follows: • 150 mcg for children 7.5-20kg • 300 mcg for children over 20kg and adults • 300 mcg or 500 mcg for children and adults over 50kg If adrenaline is accidentally injected (e.g. into a thumb) phone your local poisons information centre. Continue to follow this plan for the person with the allergic reaction. Anaphylaxis is a severe allergic reaction that can be life-threatening. Things that can cause allergic reactions are called allergens. Anaphylaxis (an-eh-fih-LAK-siss) most often happens during allergic reactions to: Anaphylaxis can be scary. But being prepared will help you treat a reaction quickly. What Are the Signs & Symptoms of Anaphylaxis?Severe allergic reactions can cause:
Anaphylaxis can cause different symptoms at different times. An allergic reaction is considered anaphylaxis if someone has:
A person with symptoms of anaphylaxis needs treatment right away. How Is Anaphylaxis Treated?Someone with anaphylaxis needs help right away. The reaction can get worse very quickly. Doctors usually want people with severe allergies to carry epinephrine auto injectors. The medicine epinephrine enters the bloodstream and works quickly against serious allergy symptoms. The injectors should always be with a child who has severe allergies, including at school, sports, jobs, and other activities. The auto injectors are small and easy to use. If the doctor prescribes epinephrine auto injectors for your child, they will show you how to use them. Two auto injectors should always be with your child in case one injector does not work or your child needs a second dose. The doctor also might instruct you to give your child antihistamines in certain cases. But always treat a serious reaction with epinephrine. Never use antihistamines instead of epinephrine in serious reactions. Anaphylaxis is when you get severe allergic reactions. Examples include reactions to certain foods or particular insect stings. Going into anaphylactic shock can be life-threatening. If you notice symptoms of anaphylaxis, such as having trouble breathing, use an epinephrine injector. This anaphylaxis treatment can save your life.
OverviewWhat is anaphylaxis?Anaphylaxis (an-ah-fi-LAK-sis) is a severe allergic reaction. It can be life-threatening if you don’t get treatment right away. Food allergies are one of the main causes of anaphylaxis. What is an allergic reaction?When you are allergic to something, your immune system overreacts by releasing chemicals like histamine. These chemicals cause symptoms such as itchy, watery eyes and a runny nose. Usually, the symptoms happen in one location of the body. But in some people, the reaction is more severe, resulting in anaphylaxis. Symptoms include swelling, wheezing, shortness of breath and difficulty swallowing. An anaphylactic reaction affects several areas of the body at once. What is anaphylactic shock?A person who has an anaphylactic reaction can go into anaphylactic shock. Blood pressure drops severely. The bronchial tissues, which help carry air, swell. These reactions cause wheezing, shortness of breath and even loss of consciousness. Anaphylactic shock requires immediate treatment to save the person’s life. How common is anaphylaxis?Anaphylaxis is common in the United States. Existing data show it occurs in about one in 50 people. But many researchers believe the rate is even higher, possibly closer to one in 20 people. Symptoms and CausesWhat causes anaphylaxis?Food allergies are one of the main causes of anaphylaxis. Foods that can cause this severe anaphylactic reaction include:
Other allergens (substances that cause allergies) that can lead to anaphylaxis include:
Does pollen cause anaphylaxis?Pollen and other allergens that you breathe in rarely cause anaphylaxis. What are the symptoms of anaphylaxis?Anaphylaxis usually begins with severe itchiness in the eyes or face. Within a few minutes, you may start experiencing more severe symptoms, including:
If you notice symptoms, get medical help right away or use your allergy medication. Without treatment, more severe, life-threatening anaphylaxis symptoms may occur:
When do symptoms of anaphylaxis start?Usually, symptoms start within five to 30 minutes of coming into contact with the allergen. For example, you might get stung by a bee or eat something with peanuts. But symptoms can sometimes start more than an hour later. What is biphasic anaphylaxis?Biphasic anaphylaxis is when you have a second wave of symptoms after the first symptoms go away. This second wave can be hours or even days after the first wave. About 20% of people who have anaphylaxis get biphasic anaphylaxis. Diagnosis and TestsHow is anaphylaxis diagnosed?If you’ve had an allergic reaction to food or insect stings (even a mild one), talk to your healthcare provider. A provider can often diagnose anaphylaxis based on your symptoms. Taking this important step can protect your health and even save your life. It applies to anyone who’s had any type of allergic reaction. If you have, you face a greater risk of developing a severe anaphylactic reaction in the future. Getting a diagnosis is necessary to get the treatment you need. What tests can diagnose anaphylaxis?An allergist (allergy specialist) may recommend testing your skin and blood. These tests can confirm the substances that cause severe reactions. A skin test places a small amount of the allergen on your skin to see if it causes a reaction. A blood test that measures tryptase can be helpful if obtained within one to three hours of the allergic reaction. Management and TreatmentHow is anaphylaxis treated?If you’ve had allergic reactions to food or insect bites, your provider will prescribe an epinephrine (adrenaline) injection. Adrenaline treats the symptoms caused by the reaction. You carry around the injector, about the size of a larger marker, wherever you go. If you experience an anaphylactic reaction, you inject yourself with the medication, usually in your thigh. These shots work quickly to reverse symptoms. If symptoms don’t improve after five to 15 minutes, give yourself a second injection, if you have one available. After injecting yourself, get medical help or call 911. You need a medical evaluation after having an anaphylactic reaction. How can I tell if someone is having an anaphylactic reaction?Look for these signs, usually involving the nose, mouth, skin or digestive system:
What should I do if someone near me is going into anaphylactic shock?If you are nearby when someone is having an anaphylactic reaction, call 911 or get medical help immediately. The person may need CPR as well. Other ways to help:
What other anaphylaxis treatments might be necessary in emergencies?If the person can’t breathe, medical professionals may need to:
Providers may need to give other treatments for shock, including:
PreventionCan I prevent anaphylaxis?If you have severe allergies, make sure you carry an epinephrine injection wherever you go. Take steps to avoid your triggers:
What is drug desensitization?Sometimes, you need to take a medication that you’re allergic to. For example, certain chemotherapy medications to treat ovarian cancer may cause an allergic reaction. There may be no safe alternative. A healthcare provider, usually an allergist or immunologist, can do drug desensitization. This helps your body temporarily accept the medicine. The provider gives you a very small dose of the medicine. Over a few hours, they gradually increase the dose until you’ve received the full amount. You continue to take the medicine regularly. Doing so keeps you in this temporary non-allergic state. Once you stop taking the medication, you’ll be allergic to it again. What is venom immunotherapy?This therapy helps you become less allergic to insect bites. An allergist injects small doses of the venom under your skin. You get a series of these shots, which decrease your sensitivity to the allergen. What is oral immunotherapy for food allergies?This therapy tries to desensitize someone to a food allergy by reducing the reaction. You do so under the care of a healthcare provider, usually an allergist. The provider starts by giving you a small dose of the allergen, then slowly increases it over time. The goal is building your tolerance. People who have oral immunotherapy should still carry their epinephrine injector with them. Researchers are investigating how effective this therapy is. Outlook / PrognosisWhat’s the outlook for people who had an anaphylactic reaction?When people don’t get treatment in time, anaphylaxis may lead to unconsciousness and even death. But if you get prompt treatment with epinephrine, the prognosis is good. You’ll likely make a full recovery. Living WithHow can I best cope with allergies?If you know you have severe allergies to food or other things, prepare ahead of time:
When should I use my epinephrine injector?If you think you’re having an anaphylactic reaction, don’t wait to use your injector. And don’t take an antihistamine instead to see if that helps. Use your injector immediately. Your life depends on taking quick action. You also need to call 911 or get to a hospital. Even after you inject yourself, you need medical evaluation and treatment. If you’re not sure you’re having an anaphylactic reaction, it’s better to inject yourself. The risk of an unnecessary injection is less than the risk of not getting the medicine in time. If you inject yourself without needing to, you may increase your blood pressure and heartbeat for a few hours. Call your provider or get medical help if that happens. What do I need to do after an epinephrine injection?Call 911 or find a way to get to the hospital. You need to get to the nearest emergency room if you had an anaphylactic reaction. You need a full evaluation from medical professionals. When should I see an allergist?An allergist is a healthcare provider specially trained to diagnose and treat people with allergies. They can help you figure out your triggers, discuss treatment options and help you avoid allergens. Talk to an allergist if you:
If my child has allergies, what should I do?If your child has allergies, help keep them safe:
A note from Cleveland Clinic Anaphylaxis is when you have a severe allergic reaction to an allergen, such as a certain food or insect bite. Anaphylactic shock can be life-threatening. If you notice anaphylaxis symptoms, inject yourself with epinephrine right away. Then call 911 or get to the emergency room. Prompt anaphylaxis treatment can save your life. Make sure to carry your injector wherever you go. Try to avoid triggers. If you have allergy symptoms that are hard to control or you went into anaphylactic shock, talk to your healthcare provider. Share Facebook Twitter LinkedIn Email Print Last reviewed by a Cleveland Clinic medical professional on 01/13/2021. References
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What are the 3 criteria for anaphylaxis?Anaphylaxis – Indicated by any one of the following signs:
Difficulty talking or hoarse voice. Wheeze or persistent cough - unlike the cough in asthma, the onset of coughing during anaphylaxis is usually sudden. Persistent dizziness or collapse.
What steps should be taken if the nurse suspects anaphylactic shock?The management of a patient with anaphylaxis should start with the removal of exposure to the known or suspected trigger, if still possible [51], followed by the assessment of patient's circulation, airway patency, breathing, mental status, skin, and, if possible, weight [44] (Fig. 1).
What is a mild anaphylactic reaction?Anaphylaxis symptoms occur suddenly and can progress quickly. The early symptoms may be mild, such as a runny nose, a skin rash or a “strange feeling.” These symptoms can quickly lead to more serious problems, including: Trouble breathing. Hives or swelling. Tightness of the throat.
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