If someone has symptoms of anaphylaxis
Use an Adrenaline Auto-injector (EpiPen, Jext or Emerade) and administer it into the thigh.
Call 999 or 112 for an ambulance immediately (even if they start to feel better) – mention that you think the person has anaphylaxis.
If possible, lie the person down unless they’re having breathing difficulties and need to sit up to help them breathe.
Give another adrenaline injection after 5 minutes if the symptoms do not improve and a second injection is available.
Why lying down during anaphylaxis is important
During anaphylaxis, the release of allergic mediators, or chemicals like histamine, can cause the blood vessels to get bigger, dilate and become leaky. As a result, there can be massive fluid shifts out of the blood vessels causing blood and fluid to move into the surrounding tissues and make it harder for blood to return back to heart. Therefore, blood pressure drops and becomes low.
To help prevent blood pressure from suddenly dropping in someone experiencing anaphylaxis, they should lie down on the ground or sit on the ground with their legs stretched out in front of them or legs elevated. This will help ensure blood continues to flow to the heart and to other major organs in the body.
Sudden standing must be avoided as this may increase the risk of a fatal reaction. When the adrenaline autoinjector is administered, it should help reverse the symptoms by constricting the blood vessels, reducing the leakage of fluid and relaxing the airways.
While waiting for the ambulance, stay with the individual. Get another person to show paramedics where the patient is.
Let the patient lie on their back with their legs raised while waiting for the ambulance. This position will help the blood flow to the vital organs of the body (heart, brain and lungs) and help to reduce the symptoms of shock (1).
If the individual is feeling weak or dizzy, lie them down with their legs elevated. Do not try to sit them up; it may prevent blood from reaching the heart and brain.
If the patient is vomiting or feels nauseous, place them on their side or in the recovery position so that if they vomit, they will not choke. It is very important to keep their airways clear.
The paramedics should take the patient to the ambulance by stretcher. Do not make the patient stand up or walk to the ambulance unless instructed by the paramedics.
Leaving the Hospital
Ask the doctor to prescribe auto-injectors before leaving the hospital. Collect the new auto-injectors as soon as possible.
(1)Simon, E. et al. “World Allergy Organization guidelines for the assessment and management of anaphylaxis.” World Health Organization – World Allergy Organization Journal (2011) 21-22.
