CALL 911 FIRST if emergency services are available. This page is for backup/offline reference.
Severe Allergic Reaction (Anaphylaxis)
Life-threatening allergic reaction. Airway swelling, cardiovascular collapse. Common triggers: food, insect stings, medications.
Critical Warning
Anaphylaxis kills through airway obstruction and shock. Epinephrine is the ONLY first-line treatment — antihistamines are NOT enough.
Recognize the Signs
- Swelling of face, lips, tongue, throat
- Difficulty breathing or swallowing
- Wheezing, high-pitched sound on breathing
- Hives or red rash spreading quickly
- Rapid weak pulse
- Dizziness, fainting, confusion
- Nausea, vomiting, cramping
Action Steps
Call 911 immediately
Anaphylaxis can escalate in seconds. Even with epinephrine, medical care is essential.
Administer epinephrine (EpiPen)
If victim has an auto-injector: remove safety cap. Press firmly into outer thigh (through clothing is fine). Hold 3 seconds. Massage site. A second dose may be needed in 5-15 minutes if symptoms persist.
Lay victim flat
Flat on back, legs elevated (shock position) if conscious. If vomiting, turn to side. If breathing difficulty is primary, let them sit up.
Remove trigger if possible
Scrape off bee stinger with credit card edge (don't squeeze). Spit out food. Remove contact with allergen.
Loosen tight clothing
Help breathing. Remove belts, tight collars, constricting clothing around throat or chest.
Monitor airway and breathing
Be ready to start CPR. Biphasic reactions (second wave) can occur 4-12 hours later even after apparent recovery.
Do NOT Do
- Do NOT give oral medication (antihistamine pill) — too slow; person may not be able to swallow safely
- Do NOT have victim stand or walk — can cause fatal cardiovascular collapse
- Do NOT assume recovery — biphasic reactions occur up to 12 hours later
- Do NOT delay epinephrine waiting for EMS
Aftercare
Anyone who received epinephrine must go to an ER for 4-6 hours of observation minimum. Biphasic reactions are dangerous.
When to Get Professional Help
ALWAYS 911. Epinephrine is a bridge — full medical treatment with IV steroids, oxygen, and monitoring is required.