Taking action on anaphylaxis

Did you know allergies affect more than 25% of children in Europe? How prepared are you to deal with the serious risk of severe reaction among those children with allergies that you care for? Do you know how to use an EpiPen? Here Emma Hammett of First Aid for Life looks at triggers, symptoms and treatment


Nuts are the most common trigger for serious allergic reaction. Research has indicated that as many as one in 70 children in the UK is allergic to peanuts.

However, remember it is possible to react to pretty much anything and it’s worth being aware that exercise can trigger a delayed allergic reaction following exposure to an allergen.


Make yourself familiar with some of the most common symptoms of a severe allergic reaction or anaphylaxis

• Flushed skin

• A rash or hives anywhere on the body

• A feeling of acute anxiety or sense of impending doom

• Swelling of the throat and mouth, difficulty swallowing or speaking

• Alterations in heart rate – usually speeding up

• Severe asthma attack which isn’t relieved by an inhaler

• Acute abdominal pain, violent nausea and vomiting

• A sudden feeling of weakness followed by collapse and unconsciousness

Not everyone will react in the same way and an anaphylactic reaction can be difficult to diagnose and predict. Individuals can even react in different ways to the same allergen when exposed to it on other occasions.


Auto-injectors containing adrenaline are used to treat acute anaphylactic reaction. The sooner they are administered once a reaction has occurred, the more effective they are. The most common brands of auto-injectors in the UK are Epipen, Jext and Emerade.

Adrenaline reduces the most dangerous symptoms of anaphylaxis - throat swelling, difficulty breathing and low blood pressure. Adrenaline is metabolised very quickly so it is important you call an ambulance as soon as an auto-injector has been given as its effects wear off within about 10 to 15 minutes. Another injector can be given 5-15 minutes after the first if necessary.

How to use an auto-injector

Hold the injector in your dominant hand. With the other hand, remove the safety cap. Put the injector firmly into the upper, outer part of the casualty’s thigh. Remove it carefully and rub the injected area for 10 seconds. If they do not start to recover or begin to get worse, you may need to give another injector. Always phone an ambulance.

Patient positioning

Someone suffering from acute anaphylaxis is likely to be showing signs of clinical shock. Reassuring them and positioning them appropriately can make a major difference to their treatment. They should also be kept warm and dry.

If the casualty is short of breath, they should sit in an upright position to make breathing easier. Putting something under their knees to increase their circulation is also helpful.

If they are not having difficulty breathing, but are flushed and feeling dizzy, they should lie down with their legs raised to improve circulation to their vital organs.

If they’re likely to vomit, they should turn their head to one side. They should be covered and kept in this position until the paramedics arrive.

After an anaphylactic reaction

An ambulance should always be called and the patient will usually be admitted overnight for observation.

For a free copy of either of the posters, please email

First Aid for Life provides this information for guidance and it is not in any way a substitute for medical advice. First Aid for Life is not responsible or liable for any diagnosis made or actions taken based on this information.

In order to register, childcarers need to complete a 12-hour paediatric first-aid course. AlL newly qualified Level 2 and Level 3 childcarers must have either an emergency paediatric first-aid or full paediatric first-aid certificate.

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