Anaphylaxis: Emergency Response: A Beginner-Friendly Start
Anaphylaxis: Emergency Response: the few things that matter most, and the mistakes that catch people out early.
A severe, rapid-onset allergic reaction affecting breathing or circulation.
Key takeaways
- First-line treatment: epinephrine, injected into the outer thigh
- Second dose: may be given 5 to 15 minutes later if symptoms do not improve
- Most useful single change: Use the epinephrine auto-injector immediately at the first sign.
- Commonest mistake: Standing the person up or letting them walk, which can be fatal.
- See a doctor if any of the signs under "When to speak to a doctor" below apply to you.
Why bother
Epinephrine is the first-line treatment and delay is a major cause of death, so recognition and speed are everything.
Start here
Just these two to begin with. The rest can wait.
- Use the epinephrine auto-injector immediately at the first sign
- Call 911 straight after
Then add these
When those have settled in, these are worth adding.
- Lie the person flat with legs raised
- Carry two auto-injectors and check the expiration dates
The numbers, in one place
| Measure | Figure |
|---|---|
| First-line treatment | epinephrine, injected into the outer thigh |
| Second dose | may be given 5 to 15 minutes later if symptoms do not improve |
| Position | lie flat with legs raised; sit up only if breathing is difficult |
| Antihistamines | do not treat anaphylaxis and must never delay epinephrine |
Common early mistakes
- Standing the person up or letting them walk, which can be fatal
- Waiting to see whether symptoms settle
- Relying on an antihistamine instead of epinephrine
Related topics
- Anaphylaxis: What Published Guidance Supports (Allergies)
- Hay Fever: What Published Guidance Supports (Respiratory Health)
- The Evidence on Stress, Without the Hype (Mental Health)
- Itching: What the Evidence Actually Says (Skin Health)
Where to go next
- What People Get Wrong About Anaphylaxis: Emergency Response
- Anaphylaxis: Emergency Response: Common Questions Answered
- Anaphylaxis: Emergency Response — the reference entry
- Emergency Care: The Complete Guide
- What the Guidance Really Says About Suspected Stroke
- Suspected Heart Attack: Sorting the Evidence From the Noise
When to speak to a doctor
Call 911 immediately for swelling of the lips, tongue or throat, difficulty breathing or swallowing, a hoarse voice, wheezing, widespread hives with faintness, or collapse. Use epinephrine first, then call. Always go to the ER even if symptoms resolve, because they can return hours later, and see your doctor afterward about an allergy plan.
Where this comes from
- American Academy of Allergy, Asthma & Immunology — Anaphylaxis
- National Institute of Allergy and Infectious Diseases — Anaphylaxis
How this page was put together
Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarized or generalized beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.
Medical disclaimer
This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to your doctor, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 911.
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