Allergic Reaction/Anaphylaxis

• Assist with or administer (if trained) medication (epinephrine).
• Continue checking them as appropriate to determine if additional care is needed.
• Keep them from getting cold or overheated.
• Give care for shock, if necessary.
• Position the person so they are comfortable.
• Reassure them you will help and that EMS has been called (if appropriate).
• Watch for changes in condition, including breathing and responsiveness.

1. Trained
   1. Have them sit in a comfortable position or lie down if showing signs of shock.
   2. Verify the medication with them.
   3. Remove the cap and safety device on the auto-injector or nasal spray.
   4. If autoinjector: Locate the outside middle of one thigh to use as the injection site.
      1. Hold their leg firmly.
      2. Administer the medication at a 90-degree angle.
      3. Hold it in place for 3 seconds after a click is heard.
      4. Massage the injection area for 10 seconds.
   5. If nasal spray: Insert the tip into one nostril and press the plunger firmly to release the dose.
   6. Note the time of administration and any changes in condition.
   7. If they have signs and symptoms 5 to 10 minutes after the first dose and EMS has not arrived, administer a second dose from a new auto-injector or nasal spray.
   8. Give the used medication device to EMS on arrival.
2. Untrained
   1. Have them sit in a comfortable position or lie down if showing signs of shock. Give them the epinephrine auto-injector.
   2. Hold their leg firmly to limit movement.
   3. Encourage use of the auto-injector or nasal spray as prescribed.
      1. For auto-injector: Make sure they hold the auto-injector firmly in place for 3 seconds after a click is heard.
         • Massage or have them massage the injection area for 10 seconds.
      2. For nasal spray: Insert the tip of the spray into one nostril and press the plunger firmly to release the dose.
   4. Note time of administration and any changes in condition.
   5. If they have signs and symptoms 5 to 10 minutes after the first dose and EMS has not arrived, help them administer a second dose.
   6. Give the used medication device to EMS on arrival.

What is the difference between anaphylaxis and an allergic reaction?

An allergic reaction can range from mild to severe. A person with a mild to moderate allergic reaction may develop a skin rash; a stuffy nose; red, watery eyes; abdominal cramps or nausea. The skin or body area in contact with the allergen may swell, turn red.

Anaphylaxis is a life-threatening allergic reaction that can cause shock and affect the person’s ability to breathe. A person with anaphylaxis may have swelling of the face, neck, tongue or lips, hives, trouble breathing, shock or a change in responsiveness.

What is epinephrine?

Epinephrine is a drug that slows or stops the effects of anaphylaxis. If a person has a known allergy that could lead to anaphylaxis, they may have been prescribed epinephrine, available as an auto-injector or a nasal spray.

Is an epinephrine used for any allergic reaction?

No. It is used only for anaphylaxis. This medication is prescribed for a person who is known to have a severe allergy that could lead to anaphylaxis.

What if I’m alone with the person in anaphylaxis? Should I care first or call 9-1-1 first?

If you are alone, assist them with administering the medication and then call 9-1-1. If you have a mobile phone call 9-1-1 and put the phone on speaker mode and immediately begin care. If you do not have a phone, give care immediately and call 9-1-1 after you administer the medication. While you wait for help to arrive, help the person sit in a comfortable position or have the person lie down if they are showing signs of shock.

What types of things can trigger anaphylaxis?

Anaphylaxis is a severe, life-threatening allergic reaction that can be triggered by many things including venomous insect stings, certain foods (like peanuts, tree nuts, shellfish, milk, eggs, soy and wheat), animal dander, plant pollen, latex or certain medications (like antibiotics).

What is shock?

Shock is a progressive, life-threatening condition in which the body does not get enough oxygen-rich blood often due to disturbed blood flow. As a result, organs and body systems begin to fail.

Signs and symptoms include:

• Rapid, weak heartbeat
• Rapid breathing
• Pale, gray, or cool moist skin
• Altered level of responsiveness
• Excessive thirst