Anaphylaxis: A Severe Allergic Reaction
Anaphylaxis is a severe, life-threatening allergic reaction that happens very quickly. It can be caused by common triggers like certain foods, medicines, or insect stings. Recognizing the signs early and getting immediate medical help is crucial. If you suspect that you or someone nearby is having an anaphylactic reaction, seek emergency medical care right away.
Symptoms
Anaphylaxis symptoms appear very fast. They often begin within minutes after you come into contact with something you are allergic to. Common triggers include certain foods, medicines, or insect stings.
Symptoms can include:
Swelling of your throat and tongue.
Trouble breathing, or breathing very quickly.
Difficulty swallowing, a feeling of tightness in your throat, or a hoarse voice.
Wheezing, coughing, or noisy breathing.
Feeling very tired or confused.
Feeling lightheaded, dizzy, or losing consciousness (fainting).
Skin that feels cold to the touch.
Your skin, lips, or tongue might look blue, grey, or very pale. If you have darker skin, these changes might be easier to see on the palms of your hands or the soles of your feet.
You might also see a rash that is swollen, raised, or itchy.
Red flags
If you notice any of these signs, seek emergency medical help right away.
The lips, mouth, throat, or tongue suddenly swell.
Breathing becomes very fast or difficult. The person might make a whistling sound (wheezing). They might feel like they are choking or gasping for air.
The throat feels tight, or swallowing is hard.
Skin, tongue, or lips turn blue, grey, or pale. For people with darker skin, check the palms of their hands or soles of their feet for this change.
The person suddenly becomes confused, sleepy, or dizzy.
Someone faints and cannot be woken up.
A child becomes limp or floppy. They do not respond as they normally would. For example, their head might fall to the side. They might find it hard to lift their head or focus on your face.
The person who is unwell may also have a rash that is swollen, raised, or itchy.
These signs can mean a serious allergic reaction. The person needs immediate treatment in a hospital.
Self-care
If you think you or someone nearby is having an anaphylactic reaction, follow these steps immediately:
1. Use an adrenaline auto-injector: If you have an auto-injector (like an EpiPen or similar device), use it right away. Follow the specific instructions printed on the device.
2. Get emergency help: Call for emergency medical assistance immediately. Clearly state that you suspect anaphylaxis.
3. Lie down carefully: Lie flat on your back. You can raise your legs slightly. If you have trouble breathing, try raising your shoulders or sitting up slowly. If you are pregnant, lie on your left side.
4. Remove insect sting: If an insect sting caused the reaction and it is still in the skin, gently remove it.
5. Use a second auto-injector: If your symptoms do not improve after 5 minutes, use a second adrenaline auto-injector.
Important: Do not stand or walk, even if you start to feel better. Keep lying down until medical help arrives.
You can take several steps to prevent anaphylactic reactions or be ready if one happens:
Things to do:
Avoid your triggers: Stay away from the food, medicine, or other things you are allergic to. For example, if you have a food allergy, always check food labels carefully. Tell restaurant staff about your allergy before you order.
Carry two auto-injectors: Always keep two adrenaline auto-injectors with you.
Check expiry dates: Regularly check the expiry dates on your auto-injectors. Get new ones before they expire.
Practice using it: Learn how to use your auto-injector correctly. You can use a trainer injector for practice (this is a device without a needle or medicine). Ask your doctor or pharmacist about how to get one.
Educate others: Teach your family, friends, colleagues, or caregivers how and when to use your auto-injector in an emergency.
Use it early: If you suspect you are having anaphylaxis, use your auto-injector even if your symptoms seem mild.
Wear medical alert jewelry: Wear a medical alert bracelet or necklace that explains your allergy. This helps others know how to assist you in an emergency.
Treatment
Anaphylaxis is a medical emergency that requires immediate treatment in a hospital.
In the hospital, doctors will give you important treatments. These often include:
Adrenaline, given as an injection or through a vein (intravenous drip).
Oxygen, to help you breathe.
Fluids, given through a vein (intravenous drip).
After initial treatment, you will usually stay in the hospital for observation. This stay typically lasts from 2 to 12 hours. Sometimes, you might need to stay longer.
Before you go home, hospital staff should give you two adrenaline auto-injectors, or a prescription for them. These are for you to keep at home in case you have another severe allergic reaction. An adrenaline auto-injector is a special, easy-to-use device that lets you inject adrenaline yourself during an emergency. It is very important that you are shown how to use your auto-injector. You should receive training each time you get a new device.
You might also be referred to an allergy specialist. This doctor can perform more tests to find the cause of your allergy and provide further advice.
Questions to ask your doctor
Here are some helpful questions to ask your doctor when discussing anaphylaxis:
Understanding your condition
What do you think triggered my allergic reaction?
How likely am I to have another reaction?
Should I see an allergy specialist for further testing?
Managing your allergy
Which foods, medicines, or other things should I avoid?
How can I find out exactly what I am allergic to?
Using your auto-injector
Can you show me how to use my adrenaline auto-injector correctly?
How many auto-injectors should I carry, and where should I keep them?
What should I do if I accidentally use my auto-injector?
Recognising a reaction
How will I know when to use my auto-injector?
What should I do first if I feel a reaction starting?
When should I call for emergency help even if I have already used my auto-injector?
Everyday life and prevention
Are there any activities or situations I should be especially careful about?
What information should I share with my family, friends, or workplace?
Should I wear a medical alert bracelet?
Follow-up care
How often should I come back for check-ups?
Are there any long-term treatments that could reduce my risk of a severe reaction?
Nepal pathway
In Nepal, start with your nearest health post, primary health care centre, clinic, or hospital if symptoms are worrying, severe, worsening, or not improving. Take previous prescriptions, test reports, allergy information, and current medicines with you. Seek urgent care immediately if there are red flag symptoms.
Disclaimer
This is general health information only and does not replace medical advice, diagnosis, treatment, or emergency care.