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Anaphylaxis - Treatment

Alternative Names

Anaphylactic reaction; Anaphylactic shock; Shock - anaphylactic

Treatment:

Anaphylaxis is an emergency condition requiring immediate professional medical attention. Call 911 immediately.

Check the person's airway, breathing, and circulation (the ABC's of Basic Life Support). A warning sign of dangerous throat swelling is a very hoarse or whispered voice, or coarse sounds when the person is breathing in air. If necessary, begin rescue breathing and CPR.

  1. Call 911.
  2. Calm and reassure the person.
  3. If the allergic reaction is from a bee sting, scrape the stinger off the skin with something firm (such as a fingernail or plastic credit card). Do not use tweezers -- squeezing the stinger will release more venom.
  4. If the person has emergency allergy medication on hand, help the person take or inject the medication. Avoid oral medication if the person is having difficulty breathing.
  5. Take steps to prevent shock. Have the person lie flat, raise the person's feet about 12 inches, and cover him or her with a coat or blanket. Do NOT place the person in this position if a head, neck, back, or leg injury is suspected, or if it causes discomfort.

DO NOT:

  • Do NOT assume that any allergy shots the person has already received will provide complete protection.
  • Do NOT place a pillow under the person's head if he or she is having trouble breathing. This can block the airways.
  • Do NOT give the person anything by mouth if the person is having trouble breathing.

Paramedics or physicians may place a tube through the nose or mouth into the airways (endotracheal intubation) or perform emergency surgery to place a tube directly into the trachea (tracheostomy or cricothyrotomy).

The person may receive antihistamines, such as diphenhydramine, and corticosteroids, such as prednisone, to further reduce symptoms (after lifesaving measures and epinephrine are given).

Expectations (prognosis):

Anaphylaxis is a severe disorder that can be life-threatening without prompt treatment. However, symptoms usually get better with the right therapy, so it is important to act right away.

Complications:

  • Airway blockage
  • Cardiac arrest (no effective heartbeat)
  • Respiratory arrest (no breathing)
  • Shock

Calling your health care provider:

Call 911 if you develop severe symptoms of anaphylaxis. If you are with another person, he or she may take you to the nearest emergency room.

  • Reviewed last on: 5/2/2010
  • David C. Dugdale, III., MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Stuart I. Henochowicz, MD, FACP, Associate Clinical Professor of Medicine, Division of Allergy, Immunology, and Rheumatology, Georgetown University Medical School. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Schwartz LB. Systemic anaphylaxis, food allergy, and insect sting allergy. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 274.

Simons FE. Anaphylaxis. J Allergy Clin Immunol. 2008;121:S402-S407.

Wasserman SI. Approach to the person with allergic or immunologic disease. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 270.

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