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Severe Allergic Reaction (Anaphylaxis)

Swelling, throat tightness, breathing trouble. Epinephrine and 112.

criticalHIGH-CONFIDENCE GUIDANCEReviewed 2026-08-18
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RECOGNIZE

  • Swelling of the face, lips, tongue or throat.
  • Throat tightness, hoarse voice, noisy breathing or wheeze.
  • Widespread hives, flushing or intense itching.
  • Vomiting, diarrhoea or severe abdominal cramps after exposure.
  • Dizziness, collapse, pale clammy skin — signs of dangerously low blood pressure.

CALL

  • Call 112 for any suspected anaphylaxis, even if an auto-injector has already been used.
  • Call 112 immediately if there is any breathing difficulty or swelling of the throat.

DO NOW

  1. 1REMOVE THE TRIGGER IF YOU CANStop the food, medicine or sting exposure if it is still happening.
  2. 2USE THEIR PRESCRIBED AUTO-INJECTORIf the person has their own epinephrine auto-injector, help them use it exactly as their device instructs.
  3. 3CALL 112 NOWSay clearly: severe allergic reaction, breathing affected.
  4. 4POSITION THEM SAFELYLie them flat with legs raised; if breathing is hard, let them sit up. Do not let them stand or walk.
  5. 5STAY AND WATCHSymptoms can return. Stay with them until the ambulance arrives.
  6. 6IF BREATHING STOPSStart CPR immediately.

DO NOT DO

  • DO NOT rely on antihistamine tablets or syrup instead of epinephrine — they do not treat anaphylaxis.
  • DO NOT make the person stand up or walk to the car.
  • DO NOT leave them alone, even if they improve.
  • DO NOT give anything by mouth if the throat is swelling or they are drowsy.
  • DO NOT use someone else's prescribed auto-injector unless a health professional directs you.

WHILE WAITING FOR HELP

  • Keep them lying flat with legs raised unless breathing is easier sitting up.
  • Note the time the reaction started and the time the auto-injector was used.
  • Keep the used auto-injector to hand over to the ambulance crew.
  • Watch breathing continuously.

WHEN TO ESCALATE

  • No improvement or worsening after an auto-injector → tell 112 immediately; a second dose may be directed by professionals.
  • Unresponsive and not breathing normally → Cardiac Arrest flow.

AFTERCARE

  • Everyone with anaphylaxis needs hospital observation — a second wave of symptoms can occur hours later.
  • Epinephrine is the first-line treatment for anaphylaxis; people at risk should carry their prescribed device and a written allergy plan.
Open CPR Metronome

CPR rhythm · 110 per minute

PUSH

Push hard in the centre of the chest. At least 5 cm deep, not more than about 6 cm. Let the chest come fully back up each time.

Keep going until the person breathes normally or trained responders take over.

MEDICAL SOURCES

  • American Red Cross

    Focused Updates and Guidelines for First Aid

    Published / updated 2024 · Evidence reviewed for this app on 2026-08-18

  • European Resuscitation Council

    ERC Guidelines — Basic Life Support and First Aid

    Published / updated 2021 · Evidence reviewed for this app on 2026-08-18

    Open source

  • American Heart Association

    Guidelines for CPR and ECC — Basic Life Support / First Aid

    Published / updated 2020 · Evidence reviewed for this app on 2026-08-18

    Open source

This content is educational first-aid guidance and does not replace emergency medical care. Guidelines can change. Verify clinical guidance periodically.

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