Anaphylaxis

Anaphylaxis is the most severe form of an allergic reaction and has the potential to be life-threatening. Anaphylaxis occurs after exposure to an allergen such as food (eg nuts), herbal remedies, latex, insect stings (eg bees), or medicine, to which a person is already extremely sensitive.


It takes only 1 to 2 minutes for a mild allergic reaction to escalate to anaphylaxis. Some casualties may find that the symptoms they experience are always mild. For example, there may be a tingling or itching in the mouth and nothing more.

Anaphylaxis is a preventable and treatable event. The most important aspect of the management of casualties with life-threatening allergic reaction is avoidance of any known triggers such as:

  • Food - Most commonly nuts, sesame seeds, shellfish, cow milk, soy, egg and wheat.
  • Herbal remedies - Such as Royal Jelly.
  • Insect stings - Such as bees and wasps. The venom from these insects is different in each case, and therefore allergy to one does not increase the risk of reactions to another.
  • Latex allergy - Rare, but more common in some people frequently exposed to latex such as health care workers.
  • Medication - Particularly antibiotics and sometimes x-ray contrast dyes.
Casualties who have a history of anaphylaxis are often prescribed self-administered adrenaline using an EpiPen® or EpiPen® Jr. If this is the case assist the casualty to self-administer their EpiPen® adrenaline.



The most noticeable signs and symptoms are:
  • hives
  • swelling of the throat, lips, tongue, or around the eyes
  • difficulty speaking, breathing or swallowing
Other common signs and symptoms may include:
  • metallic taste in the mouth
  • generalized warmth, flushing, itching, or redness of the skin
  • chest discomfort
  • abdominal cramps, nausea, vomiting, or diarrhoea
  • increased heart rate
  • sudden feeling of dizziness or weakness
  • anxiety or a sense of doom
  • collapse
  • loss of consciousness
  • put on disposable gloves if available
  • call ‘000’ for an ambulance
  • reassurance - stay with casualty
  • if available assist with EpiPen® or EpiPen® Jr
    • remove the EpiPen® or EpiPen® Jr from the packaging
    • grasp the unit, with the black tip pointing downward
    • form a first around the EpiPen® or EpiPen® Jr with black tip down
    • pull off the gray cap
    • place black end against outer mid-thigh (with or without clothing)
    • push down hard until a click is heard of felt
    • hold in place for 10 seconds
    • remove EpiPen® or EpiPen® Jr and massage the injection area for 10 seconds
    • check black tip
      • if needle is exposed the dose has been administered
      • if not, hold black tip near outer thigh and repeat administration
    • bend the needle back against a hard surface
    • carefully put the unit (needle first) back into the carrying tube (without the gray activation cap)
    • recap the carrying tube
  • observe for relapse as severe symptoms sometimes recur after apparent recovery
  • further EpiPen® does may be given if no response after 5 minutes
  • never put thumb, fingers, or hand over black tip
  • DO NOT remove gray activation cap until ready to use
EpiPen® Jr is generally prescribed for children aged 1-5 years.

Medical observation in hospital for at least 4 hours is recommended after anaphylaxis.

Useful Resource Australasian Society of Allergy and Clinical Immunology (ASCIA)
http://www.allergy.org.au