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Treatment of anaphylaxis

The most important treatment of anaphylaxis is the prompt administration of adrenaline, which should be injected into a muscle. This counteracts the effects of histamine.

Recovery from anaphylaxis is usually quite rapid and, once you are stabilised, doctors will then investigate the cause of the reaction, unless there is an obvious link to a wasp or bee sting, for example.

Investigations should ideally be carried out by a trained allergist and will include a detailed history, skin tests and/or blood tests. Before you are discharged from hospital you will given an adrenaline auto-injector such as EpiPen® or equivalent and instructed how to correctly use it as required.

It is especially important that your GP knows if you have an allergic reaction to an antibiotic, so that this is recorded in your notes.

Living with anaphylaxis

People who are identified as being at risk of anaphylaxis are encouraged to have a personal written management plan, which is drawn up in consultation with a Consultant Allergist. Evidence suggests that personal management plans reduce the frequency and severity of future episodes. As well as avoiding exposure, a personal anaphylaxis management plan can remind you that:

  • You need to carry your adrenaline auto-injector with you at all times in case you are exposed to the allergen that affects you.
  • You need to inform and remind your family and friends as to how to deal with an attack if it happens again.
  • You need to wear a wrist band or tag that identifies you as being prone to anaphylactic shock; this will help the emergency services if they need to treat you.

What to do if someone is in anaphylactic shock

Any case of anaphylaxis, even if mild at first, should be viewed as a medical emergency. So, if you are with someone who goes into anaphylactic shock, you should immediately call for an ambulance.

While waiting for the ambulance, your priority is to make sure that the affected person can breathe, so check the affected person’s pulse and breathing. If the anaphylaxis is induced by a bee sting, remove the sting as quickly as possible. In addition:

  • If the affected person is conscious: make sure the person is flat with their legs raised. Loosen clothing.
  • If the affected person is unconscious: lean the head back. Place one arm under the chin to further raise the head. Again, loosen clothing. Make sure that their head lies to the side; this is to ensure that vomiting, if it occurs, does not cause choking.
  • If the affected person stops breathing or his or her heart stops: perform cardiopulmonary resuscitation. This involves deeply compressing the chest at a rate of 100 times per minute or more. You may also perform mouth-to-mouth resuscitation.
  • Under no circumstances give the affected person food or drink.

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