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In an emergency

Emergency action | Videos on how to give adrenaline injectorTips for calling the ambulance | Once the ambulance arrives | At the hospital | After a reaction | A&AA for Support


Knowing what to do in an emergency is an important part of allergy care. If someone is showing signs of an allergic reaction including anaphylaxis (a severe allergic reaction) or you are unsure:

REMEMBER ALWAYS follow instructions on the ASCIA Action Plan for AnaphylaxisASCIA Action Plan for Allergic Reaction or the ASCIA First Aid Plan for Anaphylaxis

If you do not have an ASCIA Action Plan with you, these are the actions to take if you think someone is having anaphylaxis:

1. LAY PERSON FLAT - do NOT allow them to stand or walk

  • If unconscious or pregnant, place in recovery position - on left side if pregnant

  • If breathing is difficult allow them to sit with legs outstretched

  • Hold young children flat, not upright

   

Image supplied by ASCIA

2. GIVE ADRENALINE INJECTOR if available

3. Phone ambulance – triple zero - 000 (AU)

4. Phone family/emergency contact 

5. Further adrenaline may be given if no response or person more unwell after 5 minutes

6. Transfer person to hospital for at least 4 hours of observation

 person having anaphylaxis being carried on a trolley bed to the ambulance

 Image supplied by ASCIA 

IF IN DOUBT GIVE ADRENALINE INJECTOR

Start CPR at any time if person is not responding to you and not breathing normally

Start CPR at any time if person is not responding to you and not breathing normally 

  Image supplied by ASCIA

ASCIA Anaphylaxis Action Plan Red General ASCIA Anaphylaxis Action Plan for Allergy ASCIA Anaphylaxis First Aid Plan


ADRENALINE IS LIFE SAVING medication for someone having a severe allergic reaction. An adrenaline injector is a device containing one dose of adrenaline. They are designed to be used by people who are not medically trained.

There are two different brands available in Australia, Anapen® and EpiPen®. They both contain one dose of adrenaline. Instructions on how to give the adrenaline injector are on each device and on the ASCIA Action Plan for Anaphylaxis and the ASCIA First Aid Plan for Anaphylaxis.

Videos on how to give adrenaline injector:

  EpiPen® administration

  Anapen® administration 

More information and frequently asked questions on adrenaline injectors  can be found at: ASCIA Adrenaline injectors

More videos:

 Signs and symptoms of allergic reactionSigns and symptoms of allergic reaction

 

How to position a child or an adult having a severe allergic reaction anaphylaxisHow to position a child or an adult having a severe allergic reaction (anaphylaxis) 


Other important things to remember:

Antihistamines DO NOT stop anaphylaxis. Antihistamines only help with mild/moderate symptoms like itching or swelling of the face, lips and eyes.

DO NOT SHOWER.  Showering during a severe allergic reaction can lower the person’s blood pressure and make them more unwell.

ALWAYS give adrenaline injector FIRST, and then asthma reliever puffer if someone with known asthma and allergy to food, insects or medication (who may have been exposed to the allergen) has SUDDEN BREATHING DIFFICULTY (including wheeze, persistent cough or hoarse voice) even if there are no skin symptoms.

If in doubt, give the adrenaline injector if available.

The person having anaphylaxis may not been thinking clearly.

  • Make sure someone stays with the person having anaphylaxis.

  • Try to remain calm, reassure the person and tell them help is on its way.

  • Don’t expect the person having anaphylaxis to manage the emergency on their own if help is available.

  • A person having anaphylaxis may not be able to administer their own adrenaline injector even if they know how to use it.


Tips for calling the ambulance

Dial triple zero (000) and ask for ambulance

The ambulance operator will want to know:

  • The exact address of the emergency (anaphylaxis)

  • Nearest cross streets or landmarks

  • The phone number you are calling from

  • That the person is having a severe allergic reaction (anaphylaxis)

  • The age of the person having anaphylaxis

  • If they are conscious, if they are breathing

  • Medications which have been given (e.g. adrenaline injector, antihistamine)

Remember to try to keep calm and speak slowly and clearly. Stay focused and answer the ambulance operator’s questions.

Stay on the phone and don't hang up until the operator tells you to.

If you are the person having anaphylaxis and are alone – call triple zero (000) even if you are having difficulty talking.

Emergency service may be able to find your location if you are calling from a mobile or landline.

Another option is to use the Emergency Plus app which gives your GPS location when you call triple zero (000) through the app.

If you are alone:

Alone and experiencing anaphylaxis - Allergy & Anaphylaxis Australia (allergyfacts.org.au)


Once the ambulance arrives

The paramedics will assess the emergency and will give the person adrenaline before they get to hospital if needed.

The person having anaphylaxis should be taken to the nearest emergency department by ambulance for further treatment and observation. It is important that the person does not stand or walk to the ambulance even if they think they can or paramedics ask them to. They should be kept in a lying position or if breathing is difficult, sitting on stretcher with legs  outstretched in front of them (see Acute Anaphylaxis Clinical Care standard below).

The person should go to hospital and stay for at least four hours observation and possible further treatment, even if they look and feel well. After anaphylaxis, people can suddenly become unwell again so observation in a medical setting is important.

Things to take with you to the hospital if you can (don’t leave the person having anaphylaxis alone, or stand/walk if you are the person having anaphylaxis):

  • Extra/unused adrenaline injectors

  • Copy of your ASCIA Action Plan

  • Own food/snacks

  • Mobile phone and charger

  • Any other medication the person takes regularly

  • Medicare card

  • Private health fund information


At the hospital

For information on best practice in recognising and treating anaphylaxis see:

Acute Anaphylaxis Clinical Care Standard (CCS) - (2021), Australian Commission on Safety and Quality in Health Care

It outlines what you should expect while you are in hospital, including what you need before you go home.

On arrival at the hospital the patient :

  • will be assessed by hospital staff (CCS Quality Statement 1)

  • should not be left alone

  • should not stand, walk or sit in a chair with their legs hanging down. They should be placed on a stretcher or a bed. If they are sitting in a chair their legs should be outstretched on another chair. (CCS Quality Statement 3)

  • should not be held upright with legs hanging or sit with their legs hanging if a baby or child being held by an adult. They should lay flat or sit with legs outstretched. (CCS Quality Statement 3)

  • should stay at the hospital for a minimum of 4 hours after the last dose of adrenaline.

Before leaving hospital you should get (CCS Quality Statement 6):

  • Information about what could have caused the severe allergic reaction and how to avoid it

  • An ASCIA Action Plan if you don’t have a current one or it needs updating

  • Advice to see your general practitioner (GP) in the following day or two and information on how to make an appointment with a clinical immunology/allergy specialist

  • Advice about wearing special jewellery (necklace or bracelet) that says you have an allergy.

  • You should also be given a personal adrenaline injector or a prescription for this medicine if there is a risk of having anaphylaxis again. If you are given a prescription, it is very important that you go to a pharmacy to get the adrenaline injector as soon as possible, preferably on the way home.

  • Training on how to give an adrenaline injector if you do not know. This may be done at the pharmacy when you are getting your two adrenaline injectors.

Make sure you watch the video for the adrenaline injector you have been prescribed

  EpiPen®

  Anapen®  


After the reaction

When still fresh in your mind, write what happened when you/your child had a severe allergic reaction.

This information can be passed on to your GP and your allergy specialist when you next visit them.

ASCIA has developed an Anaphylaxis Event Record to help you keep a record of what happened.

(Used with permission from ASCIA: for more information see Anaphylaxis Event Record - Australasian Society of Clinical Immunology and Allergy (ASCIA))


Call A&AA for help and support

Once you have recovered from the emergency and been discharged from hospital, you are welcome to call one of the trained A&AA Allergy Educators on 1300 728 000 or use our contact us form.  It may help to talk about the allergic reaction and how the emergency was managed with one of our health professionals.

If you think the allergic reaction was caused by a packaged food that is incorrectly labelled or you had an allergic reaction when eating food served after telling food service staff about your food allergy, contact A&AA so they can help you with reporting the packaged food or the restaurant/cafe/event venue.

Content updated May 2024