Anaphylaxis is a severe allergic reaction and potentially life threatening. It should always be treated as a medical emergency, requiring immediate treatment. Most cases of anaphylaxis occur after a person with a severe allergy is exposed to the allergen they are allergic to (usually a food, insect or medication).
MILD TO MODERATE ALLERGIC REACTION
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 (these are signs of a mild to moderate allergic reaction to most allergens, however, in insect allergy these are signs of anaphylaxis).
- 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 (whilst non-drowsy antihistamines may be used to treat mild to moderate allergic reactions, if these progress 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 be stored with the adrenaline autoinjector)
- Contact parent/guardian or other emergency contact.
ANAPHYLAXIS (SEVERE ALLERGIC REACTION)
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
- Persistent dizziness or collapse
- Pale and floppy (in young children)
- Lay person flat - if breathing is difficult, allow to sit - do not allow them to stand or walk
- Give the adrenaline autoinjector if available (instructions are included in the ASCIA Action Plan for Anaphylaxis, stored with the adrenaline autoinjector)
- Call Ambulance (Telephone 000 in Australia, 111 in New Zealand)
- Contact parent/guardian or other emergency contact
- 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.
Commence CPR at any time if person is unresponsive and not breathing normally.
If uncertain whether it is asthma or anaphylaxis, give adrenaline autoinjector FIRST, then asthma reliever.
- Adrenaline is life saving and must be used promptly. Withholding or delaying the giving of adrenaline can result in deterioration and death . 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.
- Adrenaline autoinjectors available in Australia and New Zealand include EpiPen and EpiPen Jr. EpiPen Jr is generally prescribed for children aged 1 to 5 years.
© ASCIA 2015
For further information on anaphylaxis visit www.allergy.org.au - the web site of ASCIA.
ASCIA is the peak professional body of clinical immunology/allergy specialists in Australia and New Zealand.