In an emergency

REMEMBER ALWAYS follow instructions on the ASCIA Action Plan for Anaphylaxis for the individual concerned or the ASCIA First Aid Plan for Anaphylaxis which are in brief: 

1. Lay person flat - do NOT allow them to stand or walk
   - If unconscious, place in recovery position
   - If breathing is difficult allow them to sit

2. Give adrenaline (epinephrine) injector (such as EpiPen®, Anapen®) 

3. Phone ambulance - triple zero (000)

4. Phone family/emergency contact

5. Further adrenaline doses may be given if no response after 5 minutes

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

If in doubt give adrenaline injector

Commence CPR at any time if person is unresponsive and not breathing normally

Devices: EpiPen® Jr 150mcg; Anapen® Junior 150; 

Usage: As per ASCIA Guidelines for Adrenaline Autoinjector Prescription the 150mcg dose of adrenaline is for babies and children weighing between 7.5 – 20kg*

Devices: EpiPen® 300mcg; Anapen® 300;

Usage: As per ASCIA Guidelines for Adrenaline Autoinjector Prescription the 300mcg dose of adrenaline is for individuals weighing more than 20kg

Device: Anapen® 500;

Usage: As per ASCIA Guidelines for Adrenaline Autoinjector Prescription the 500mcg dose of adrenaline is for individuals weighing more than 50kg

*Babies who weigh less than 7.5kg are sometimes prescribed the Jr version (150mcg) of an adrenaline/epinephrine injector if their doctor feels it is safer for them to have the device because of their previous allergic reaction(s). The device can be administered to them following instructions on their ASCIA Action Plan for Anaphylaxis.

See a PDF of the ASCIA First Aid Plan here. 

See ASCIA Action Plans for Anaphylaxis here

See film showing Signs and symptoms of allergic reaction

See film showing EpiPen® administration

See film showing Anapen® administration

See film showing How to position a child or an adult having a severe allergic reaction (anaphylaxis)

See information about What to do if you are home (or elsewhere) alone and experience anaphylaxis

See film showing How Adrenaline Works During Anaphylaxis

See film showing The Importance of Laying Down During Anaphylaxis

FOLLOW THE INSTRUCTIONS ON THE ASCIA ACTION PLAN FOR ANAPHYLAXIS

If you believe someone is experiencing anaphylaxis you MUST GIVE the adrenaline (epinephrine) injector (e.g. EpiPen®, Anapen®) according to instruction on the ASCIA Action Plan.

ADRENALINE IS LIFE SAVING medication for someone experiencing a severe allergic reaction/anaphylaxis.

Antihistamines DO NOT stop the progression of an anaphylaxis. Antihistamines only help to decrease itching and reduce mild/moderate swelling of the face, lips and eyes.

DO NOT SHOWER as this may contribute to a drop in blood pressure which can escalate the severity of an allergic reaction.

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

Tips for calling the ambulance

Dial triple zero (000) and state calmly:

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

• Your address

• Nearest cross streets ;

• The signs and symptoms they are displaying;

• The medications which have been given (e.g. Adrenaline injector, antihistamine);

• Phone number you are calling from.

In most circumstances, if the individual requiring the ambulance is in a potentially life threatening condition, ambulance personnel will stay on the phone with you until the ambulance arrives. Once the ambulance arrives, the officers will quickly assess the emergency, administer medication if required and transport the individual to the nearest emergency department for further treatment and observation. During transport, be sure the individual is kept in a lying position or if breathing difficult, sitting on stretcher with legs extended in front of them. The individual should not stand as blood pressure can drop very quickly.

If adrenaline has been administered (by the individual, carer or paramedics) the person MUST be transported to hospital for at least four hours observation and further treatment, even if they look well. The person can suddenly become unwell again in the hours after the last dose of adrenaline so observation in a medical setting with more adrenaline and other emergency equipment on hand is crucial.

Once at the hospital:

• The nursing and medical staff will need to be informed of the sequence of events leading to you calling the ambulance. You also need to give medical background information including medication individual is currently prescribed.

• The patient must stay at the hospital for a minimum of four (4) hours after the last dose of adrenaline/epinephrine in case of the return of signs and symptoms of anaphylaxis (biphasic reaction). Some people may look like they are recovering from anaphylaxis but then suddenly go into another severe allergic reaction requiring more adrenaline (epinephrine) and hospital monitoring.

• Before leaving hospital, ask for a discharge summary or letter, which will detail the treatment received, medications administered and follow up required by your GP and allergy specialist.

• On discharge, the hospital doctor must prescribe an adrenaline (epinephrine) injector to replace the one/s used. If the patient is discharged without a prescription for an adrenaline (epinephrine) injector, they are at risk of being unprepared for a future reaction.

• Emergency doctors can prescribe an adrenaline (epinephrine) injector on the Pharmaceutical Benefits Scheme (PBS) if a person has just experienced their first allergic reaction requiring adrenaline.

• Make an appointment to see your allergist for a follow-up consultation as soon as possible. If this is your/your child’s first anaphylaxis and you have difficulty getting an appointment with an allergy specialist within 4-6 weeks please contact 1300 728 000.

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

This information can be passed on to your GP AND your allergy specialist.

ASCIA has developed an Anaphylaxis Event Record to help document what happened.

ASCIA has developed an Anaphylaxis Event Record to help document what happened.

ASCIA event record allergic reactions85.87 KB 

(Used with permission from ASCIA: for more information see
www.allergy.org.au/health-professionals/anaphylaxis-resources/anaphylaxis-event-record) 

If you are alone

What to do if you are home (or elsewhere) alone and experience anaphylaxis

What to do if you are home (or elsewhere) alone and experience anaphylaxis297.08 KB 

ACUTE ANAPHYLAXIS CLINICAL CARE STANDARD

This clinical care standard aims to improve the recognition of anaphylaxis, and the provision of appropriate treatment and follow-up care.

Acute Anaphylaxis Clinical Care Standard | Australian Commission on Safety and Quality in Health Care

SIGNS AND SYMPTOMS OF ALLERGIC REACTION

EPIPEN® ADMINISTRATION

ANAPEN® ADMINISTRATION

HOW TO POSITION A CHILD OR AN ADULT HAVING A SEVERE ALLERGIC REACTION (ANAPHYLAXIS)

This animation was developed by the National Allergy Council.

HOW ADRENALINE WORKS DURING ANAPHYLAXIS

Dr Paxton Loke - Paediatric Allergist and Immunologist from the Murdoch Children’s Research Institute (MCRI) and Melbourne Allergy Centre and Children’s Specialists Medical Group

THE IMPORTANCE OF LAYING DOWN DURING ANAPHYLAXIS

Dr Paxton Loke - Paediatric Allergist and Immunologist from the Murdoch Children’s Research Institute (MCRI) and Melbourne Allergy Centre and Children’s Specialists Medical Group

Content updated June 2023