Anaphylaxis is a potentially life threatening, severe allergic reaction and should always be treated as a medical emergency.
It is important to know the signs and symptoms of anaphylaxis
Anaphylaxis occurs after exposure to an allergen (usually to foods, insects or medicines), to which a person is already extremely sensitive. The symptoms of anaphylaxis are potentially life threatening and include any one of the following:
- 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)
In some cases, anaphylaxis is preceded by less dangerous allergic symptoms such as:
- Swelling of face, lips and/or eyes
- Hives or welts on the skin
- Abdominal pain, vomiting
Several factors can influence the severity of the allergic reaction. These include exercise, heat, alcohol, and in food allergic people, the amount eaten and 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, such as fainting or an epileptic seizure. If allergy is suspected, this may be followed by allergy tests, usually a blood test for allergen specific IgE (formerly known as RAST tests) or skin prick testing, to help confirm or exclude potential triggers. Information on allergy testing is available on the ASCIA website
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/patients/allergy-testing/unorthodox-testing-and-treatment
Effective management of anaphylaxis saves lives
If you are at risk of anaphylaxis, you will require ongoing management by your doctor. This should include:
- Referral to a medical specialist (clinical immunology/allergy specialist)*
- 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 severe food allergy as avoidance of the trigger is the only way to avoid a reaction 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 ASCIA Action Plan is essential.
- Regular follow up visits to a medical specialist (clinical immunology/allergy specialist)
* Medical specialists providing clinical immunology and allergy services are listed on the ASCIA website http://www.allergy.org.au/patients/allergy-and-clinical-immunology-services/how-to-locate-a-specialist
** Action plans (EpiPen or Anapen brand specific) must be completed by a doctor and kept with the adrenaline autoinjector as the plans include instructions on when and how to use the device. ASCIA Action Plans for Anaphylaxis are available from the ASCIA website www.allergy.org.au/health-professionals/anaphylaxis-resources/ascia-action-plan-for-anaphylaxis
Adrenaline (injected intramuscularly) is the first line treatment for anaphylaxis
Adrenaline works rapidly to reverse the effects of anaphylaxis and is the first line treatment for anaphylaxis. Adrenaline autoinjectors contain a single, fixed dose of adrenaline, and have been designed to be given by non-medical people, 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 Jr or EpiPen)
- Anapen adrenaline autoinjectors (Anapen 150 or Anapen 300. Some people may be prescribed Anapen 500.).
Patients and doctors discuss and decide which brand of adrenaline autoinjector is most suitable to their needs once the doctor advises what dose autoinjector is required. An adrenaline autoinjector should only be prescribed as part of a comprehensive anaphylaxis management plan which includes an ASCIA Action Plan for Anaphylaxis and education on how to reduce the risk of allergic reactions.
If you or your child has been prescribed an adrenaline autoinjector, it is important that you learn and practice how to use it, using a trainer device every 3-4 months.
For anaphylaxis resources (including ASCIA Action Plans, FAQs, ASCIA Travel Plans, adrenaline autoinjector information, training resources and guidelines) visit the ASCIA website www.allergy.org.au/health-professionals/anaphylaxis-resources
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 organisation websites www.allergy.org.au/patients/patient-support-information including:
Allergy & Anaphylaxis Australia - www.allergyfacts.org.au
Allergy New Zealand - www.allergy.org.nz
© ASCIA 2013
The Australasian Society of Clinical Immunology and Allergy (ASCIA) is the peak professional body of clinical immunology and allergy specialists in Australia and New Zealand.
Postal address: PO Box 450 Balgowlah, NSW Australia 2093
This 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. 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.
The development of this document is not funded by any commercial sources and is not influenced by commercial organisations.
Content last updated February 2013