First Aid Treatment for Anaphylaxis
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).
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 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.
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 them to sit but do not stand
- 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 or 112 if using a mobile phone)
- 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
- 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 are EpiPen and Anapen. The green labelled versions of EpiPen and Anapen are generally prescribed for children aged 1 to 5 years.
The ASCIA First Aid for Anaphylaxis document has been developed and peer reviewed by ASCIA members and is based on expert opinion and the available published literature at the time of review. The development of this document is not funded by any commercial sources and is not influenced by commercial organisations. Information contained in this document is not intended to replace medical advice and any questions regarding a medical diagnosis or treatment should be directed to a medical practitioner.
© ASCIA 2012
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 February 2012