Anaphylaxis is the most severe form of allergic reaction a person can have and can be life threatening. It can be caused by medication, food, bites/stings and less commonly exercise. The Most common triggers are:

• Medication
  • Over the counter medication e.g. aspirin
  • Prescription medication
  • Herbal medicine
• Venom from insect bites & stings
• Food –  Some common Food Allergens are:
  • Peanuts & tree nuts
  • Milk
  • Eggs
  • Wheat
  • Soy
  • Sesame
  • Fish & crustaceans e.g. prawns

Even a minuscule amount of food can cause a severe anaphylaxis reaction in susceptible individuals.

What is the risk to the casualty?

A severe allergic reaction can potentially compromise the airway by causing asthma like symptoms and swelling of the throat area.

Applying the principle of triage, breathing difficulties are extremely life threatening and require immediate attention.

Signs and Symptoms

The signs and symptoms can occur in as little as 5 minutes and can be manifested in any or all of the following ways:

Mild to moderate reaction

• Swelling of lips, face, eyes
• Hives or welts (refer to above image)
• Tingling in mouth,
• abdominal pain,
• vomiting

Severe reaction

• Difficult/noisy breathing
• Swelling of tongue
• Swelling/tightness in throat
• Difficulty talking and/or hoarse voice
• Wheeze or persistent cough
• Loss of consciousness or collapse
• Pale and floppy (young children)

First Aid Guideline

• Primary & Secondary Assessment
• Re-assure and calm the casualty
• Stay with person and call for help
• Locate adrenaline injector (Two brands available: EpiPen® & Anapen®. Junior versions available for children aged 1-5 years)
• Contact family/carer
• Administer adrenaline injector
• Call ambulance – 000
• If breathing is difficult, allow to sit but do not stand
• Contact family/carer
• Further adrenaline injector doses may be given if no response after 5 minutes.
• If the anaphylactic reaction has been caused by an insect sting or bite:
• Remove the stinger, if it is still present, by sweeping a fingernail or credit card across the sting
• When injected, adrenaline rapidly reverses the effects of severe allergic reactions by reducing throat swelling, opening airways and maintaining blood pressure. It is only to be injected into the outer aspect of the thigh and held in place for at least 10 seconds.Monitor airway, breathing & circulation
• Commence C.P.R. if breathing stops or becomes ineffective

Do Not

• Do not administer creams or ointments to rash prior to obtaining medical advice

Important Notes about Anaphylaxis

• Record the expiry date for the adrenaline injector and replace immediately upon expiry. Give expired unit to your pharmacist for safe disposal or place in sharps container
• Always seek immediate medical attention after using an adrenaline injector even if the recipient is seemingly okay
• Record the time that the adrenaline injector was given
• Store adrenaline injector at room temperature. Do not expose to extreme cold, heat or direct sunlight
• An adrenaline injector is a life-saving treatment in the emergency management of severe allergic reactions. Therefore, it should not be withheld from anyone who is considered to need it
• An adrenaline injector delivers one measured dose – single one time use only
• EpiPen® & Anapen® are available from chemists in single adult or child dosages

Note: This guideline is intended for use by qualified first aiders. It is not a substitute for nationally recognised training in the management of Anaphylaxis.