The Australasian Society of Clinical Immunology and Allergy

Anaphylaxis is the most severe form of allergic reaction and is potentially life threatening. Anaphylaxis should be treated as a medical emergency, requiring immediate treatment.

Anaphylaxis affects the entire body

Anaphylaxis occurs after exposure to an allergen (usually to foods, insect stings or medicines), to which a person is already extremely sensitive. It results in potentially life threatening symptoms, which include:

• Difficulty/noisy breathing
• Swelling of tongue
• Swelling/tightness in throat
• Difficulty talking and/or hoarse voice
• Wheeze or persistent cough
• Loss of consciousness and/or collapse
• Pale and floppy (in young children)

• Swelling of face, lips and eyes
• Hives or welts on the skin
• Stomach pain, vomiting

Several factors can influence the severity of anaphylaxis, including exercise, heat, alcohol and in food allergic people, the amount eaten, how it is prepared and consumed.

Identifying the cause of anaphylaxis is important 

Your doctor will normally ask a series of questions that may help to narrow down the list of likely causes such as foods or medicines consumed that day, or exposure to insects. This approach will also help to exclude conditions that can sometimes be confused with anaphylaxis like fainting attacks or epileptic fits. If allergy is suspected, this may be followed by allergy tests, usually by blood tests for allergen specific IgE (commonly known as RAST tests) or skin prick tests, to help confirm or exclude potential triggers. Information on allergy testing is available on the ASCIA website www.allergy.org.au/content/view/104/116/

It is important to note that some methods which claim to test for allergies (including cytotoxic food testing, Vega testing, kinesiology, allergy elimination techniques, iridology, pulse testing, Alcat testing, Rinkel's intradermal testing, reflexology, hair analysis and IgG food allergy testing) are not medically or scientifically proven methods to confirm allergy. Information about these tests is available on the ASCIA website www.allergy.org.au/content/view/322/271/

Effective management of anaphylaxis saves lives

If you have severe allergy and are at risk of anaphylaxis, you will require a comprehensive management plan from your doctor, which should include:

• Referral to a medical specialist (Allergist / Clinical Immunologist) *
• Identification of the trigger/s of anaphylaxis 
  This will include a comprehensive medical history and clinical examination followed by interpretation of allergy test results.
• Education on avoidance of trigger/s
  This is particularly important with food anaphylaxis and may also involve advice from an experienced allergy dietitian.
• Provision of an ASCIA action plan for anaphylaxis **
  Since episodes of anaphylaxis are often unpredictable, an action plan is essential
• Regular follow up visits to a medical specialist (Allergist / Clinical Immunologist) 

* Medical specialists providing allergy and clinical immunology services are listed on the ASCIA website www.allergy.org.au/content/view/227/60/

** ASCIA action plans for anaphylaxis (updated in 2009) are available from the ASCIA website www.allergy.org.au/content/view/10/3/   Action plans need to be completed by a doctor and stored (or carried) with the adrenaline auotinjector as the plans include instructions on how to use the device. 

Adrenaline is essential for first aid treatment of anaphylaxis

Adrenaline works rapidly to reverse the effects of anaphylaxis and should be considered essential first aid treatment.  Adrenaline autoinjectors contain a single, premeasured dose of adrenaline, and have been designed to be given by a non-medical person, such as a friend, teacher, childcare worker, parent, passer-by or by the patient themselves (if they are not too unwell to do this).    

There are 2 brands of adrenaline autoinjectors available in Australia and New Zealand:

• EpiPen adrenaline autoinjectors (EpiPen or EpiPen Jr)
• Anapen adrenaline autoinjectors (Anapen or Anapen Jr)

Since November 2003, EpiPen and EpiPen Jr have been available in Australia by authority prescription on the Pharmaceutical Benefits Scheme (PBS).  

Further Information

For Anaphylaxis resources (including Action Plans, FAQ, Travel Plans, adrenaline autoinjector information, training resources and guidelines) visit the ASCIA website www.allergy.org.au/content/view/10/3/

Having anaphylaxis yourself or in the family can sometimes be hard to cope with. Anaphylaxis support groups provide useful and supportive information from other people in the same situation. The ASCIA website includes a list of patient organization websites www.allergy.org.au/content/view/140/67/, including:

© ASCIA 2010

The Australasian Society of Clinical Immunology and Allergy (ASCIA) is the peak professional body of Clinical Immunologists and Allergists in Australia and New Zealand.

Website: www.allergy.org.au

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Postal address: PO Box 450 Balgowlah, NSW Australia 2093

Disclaimer

ASCIA Education Resources (AER) information is reviewed by ASCIA members and represents the available published literature at the time of review.  The content of this document is not intended to replace professional medical advice and any questions regarding a medical diagnosis or treatment should be directed to a medical practitioner.

Content last updated February 2010