First Aid Treatment for Anaphylaxis 2009 35.83 Kb 

Anaphylaxis is the most severe form of allergic reaction and is potentially life-threatening. It should be treated as a medical emergency, requiring immediate treatment. Most cases of anaphylaxis occur after exposure to an allergen (such as foods, insects or medications) in a person who is already extremely sensitive.

Step 1

In some cases, anaphylaxis is preceded by signs of a mild to moderate allergic reaction:

• Swelling of face, lips and eyes
• Hives or welts on the skin
• Tingling mouth
• Stomach pain, vomiting (Note - These are signs of a mild to moderate allergic reaction to most allergens, however, in insect allergy these are signs of a severe allergic reaction)

Action

• For insect allergy, flick out the sting if it can be seen (but do not remove ticks)
• Stay with person and call for help
• Give medications if prescribed (Note - Whilst antihistamines may be used to treat a mild to moderate allergic reaction, if this progresses to anaphylaxis then adrenaline is the only suitable medication.)
• Locate adrenaline autoinjector if available (instructions are included in the ASCIA action plan for anaphylaxis which should always be stored with the adrenaline autoinjector)
• Contact family/carer

Step 2

Continue to watch for any one of the following signs of anaphylaxis (severe allergic reaction):

• Difficult/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)

Action

• Give the adrenaline autoinjector if available (instructions are included in the ASCIA action plan for anaphylaxis which should always be stored with the autoinjector)
• Call Ambulance (Telephone 000 in Australia or 111 in New Zealand)
• Lay person flat and elevate legs - if breathing is difficult, allow to sit but do not stand
• Contact family/carer
• Further adrenaline doses may be given (when an additional adrenaline autoinjector is available), if there is no response after 5 minutes.

If in doubt, give the adrenaline autoinjector

NOTE: Adrenaline is life-saving and must be used promptly

• Adrenaline autoinjectors (EpiPen or Anapen) contain a single, premeasured dose of adrenaline and should be given as shown on the ASCIA action plan for anaphylaxis. They may 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). Whilst those responsible for children at risk of anaphylaxis should be trained in the recognition and emergency treatment of anaphylaxis, you do not have to be formally trained in first aid to give an adrenaline autoinjector in an emergency. EpiPen Jr or Anapen Jr are generally used for children aged 1-5 years (or weighing 10-20Kg).
• Adrenaline is a naturally occurring hormone and does not cause harm if given using an autoinjector as instructed.
• Withholding or delaying adrenaline can result in deterioration and death of the patient. This is why giving the adrenaline autoinjector is the first instruction on the ASCIA action plan for anaphylaxis. If cardiopulmonary resuscitation (CPR) is given before this step there is a risk that adrenaline is delayed or not given.
• In the ambulance oxygen will usually be administered to the patient by paramedics.
• Medical observation of the patient in hospital for at least 4 hours is recommended after anaphylaxis.

© ASCIA 2009

For further information on anaphylaxis visit www.allergy.org.au - the web site of ASCIA. ASCIA is the peak professional body of Clinical Immunologists and Allergists in Australia and New Zealand.

Content Updated October 2009