Allergic reactions emergency first aid

Allergic reactions can be an emergency#

Some allergic reactions are mild, but a severe reaction (anaphylaxis) is life-threatening and needs emergency first aid. If you have an action plan for allergies, follow it as soon as the symptoms of an allergic reaction appear.

Signs of a mild to moderate allergic reaction#

• Swelling of the lips, face and eyes
• Hives or welts
• Tingling mouth
• Abdominal pain or vomiting — for an insect allergy, these can be signs of anaphylaxis

Signs of a severe allergic reaction (anaphylaxis)#

• Difficult or noisy breathing
• Swelling of the tongue
• Swelling or tightness in the throat
• Wheeze or persistent cough
• Difficulty talking, or a hoarse voice
• Persistent dizziness or collapse
• Becoming pale and floppy (in young children)
• Abdominal pain or vomiting (signs of anaphylaxis for an insect allergy)

Mild to moderate symptoms such as hives or swelling do not always appear before anaphylaxis. If you have ever had any of these severe symptoms, you are at greater risk of another severe reaction — ask your doctor to refer you to a clinical immunology or allergy specialist.

Emergency first aid for anaphylaxis#

A severe allergic reaction is life-threatening and needs urgent action:

• Lay the person flat. Do not let them stand or walk.
• Give the adrenaline (epinephrine) injector (such as EpiPen® or Anapen®) into the outer mid-thigh.
• Call your local emergency number (for example 911 in the US and Canada, 112 across the EU and many countries, 999 in the UK, or 000 in Australia) for an ambulance.
• Phone the person’s family or emergency contact.
• A further dose of adrenaline may be given if there is no improvement after 5 minutes.
• Transfer the person to hospital for at least 4 hours of observation.

If in doubt, give the adrenaline injector. If the person is unresponsive and not breathing normally at any time, begin CPR (cardiopulmonary resuscitation).

For someone with known asthma and allergy who suddenly has breathing difficulty — including wheeze, persistent cough or a hoarse voice — always give the adrenaline injector first and then the asthma reliever puffer, even if there are no skin symptoms.

Adrenaline injectors (EpiPen® and Anapen®) are designed to be used by people who are not medically trained. Adrenaline works fast to reverse a severe allergic reaction.

Being prepared for a severe reaction#

If you are at risk of a severe allergic reaction, make sure you:

• Carry a mobile phone so you can call for help when needed.
• Carry your adrenaline injector (EpiPen® or Anapen®) to treat a severe reaction.
• Consider wearing medical identification jewelry, which makes it more likely that adrenaline will be given in an emergency.
• Where possible, avoid medications that can worsen an allergic reaction or complicate its treatment, such as beta blockers.
• Avoid the known allergen — such as a food, insect or medication — wherever possible.

If you are at risk of anaphylaxis, your doctor will prescribe an adrenaline injector and help you set up an action plan for anaphylaxis.

Emergency first aid for asthma attacks#

If you have asthma, your doctor will prescribe medication and help you develop a plan to manage it. Asthma can usually be well controlled with medication.

If you or someone you know is having an asthma attack, follow the asthma action plan. In an emergency, call your local emergency number (for example 911 in the US and Canada, 112 across the EU and many countries, 999 in the UK, or 000 in Australia) and ask for an ambulance, and tell the operator that someone is having an asthma attack.

Key points#

• Follow your action plan as soon as the symptoms of an allergic reaction appear.
• Anaphylaxis is life-threatening: lay the person flat, give the adrenaline injector into the outer mid-thigh, and call for an ambulance.
• A further dose of adrenaline may be given after 5 minutes if there is no improvement, and the person should be observed in hospital for at least 4 hours.
• If you are at risk of a severe reaction, carry an adrenaline injector and a phone, and avoid known triggers.
• Start CPR if the person becomes unresponsive and is not breathing normally.

Where to get help and trusted information#

For evidence-based global health guidance, see Source: World Health Organization (WHO).