Allergic reactions and anaphylaxis

Mild reactions

A mild reaction may cause itchy skin, a few hives, sneezing, a runny nose, or itchy, watery eyes, without any trouble breathing.

1. Move away from the cause if you know it (for example, a pet, plant, or food).
2. Wash the skin if it touched something that set off the reaction.
3. Take an over-the-counter antihistamine if needed. Follow the package directions.
4. Watch closely for signs that it is getting worse, especially in the first hour.

Anaphylaxis: what to do

Anaphylaxis can happen within minutes of contact with a trigger like a food, sting, or medicine. It doesn’t always cause hives — trouble breathing, vomiting, or feeling faint after exposure can be enough.

1. Use epinephrine right away if the person has an auto-injector or nasal spray. Don’t wait to see if it gets better. If you’re not sure, use it — it’s safer than waiting.
2. Call 911. Do this even if the person starts to feel better. Symptoms can come back.
3. Have the person lie on their back with legs raised. If they are having trouble breathing, they can sit up. If they are vomiting, turn them on their side. If they are pregnant, have them lie on their left side.
4. Don’t let them stand up or walk suddenly, even if they feel better.
5. Give a second dose if symptoms don’t improve or get worse after about 5 to 15 minutes and a second device is available.
6. Start CPR if they stop breathing normally.

How to use an epinephrine auto-injector

Instructions differ by brand, so read the device label ahead of time. Most work like this:

1. Remove the safety cap.
2. Press the tip firmly into the outer thigh. It can go through clothing.
3. Hold it in place for the time the instructions say (usually a few seconds).
4. Rub the spot for a few seconds after removing it, if the instructions say to.
5. Give the used device to EMS so they know the dose and time.

Avoid

• Don’t rely on an antihistamine pill for anaphylaxis. It works too slowly. Epinephrine comes first.
• Don’t give anything to drink if the person is having trouble breathing or swallowing.
• An expired auto-injector is better than none in an emergency.