First Aid for Allergy and Anaphylaxis: Symptoms and Treatment

First Aid for Allergy and Anaphylaxis: Symptoms and Treatment

1. Mild VS Severe Allergic Reactions

Allergic reactions occur when the body's immune system has a reaction to a substance it sees as harmful, called an allergen. Allergies are quite common and most reactions are mild. However, some reactions that seem mild can become severe within minutes.

A severe allergic reaction (anaphylaxis) is life threatening and can quickly turn into a medical emergency. Anaphylaxis causes the immune system to release a flood of chemicals that can cause the person to go into shock.

Allergens that can cause a severe allergic reaction are:

  • Foods – including nuts, seafood, milk, eggs, chocolate...
  • Medicines – including some antibiotics and drugs like aspirin.
  • Insect stings – particularly wasp and bee stings.
  • Latex
  • Vaccines

Here are some signs of mild and severe allergic reactions.

1.1. Mild allergic reactions

  • A stuffy nose,
  • Sneezing,
  • Itching around the eyes,
  • Itching of the skin,
  • Raised, red rash on the skin (hives),

1.2. Severe allergic reactions

  • Trouble breathing,
  • Nausea, vomiting or diarrhea,
  • Swelling of the tongue and face,
  • Signs of shock – including weak and rapid pulse, cold and clammy skin, pale skin, weak, dizzy, agitated, confused, thirsty.

2. Epinephrine Auto-Injectors for a Severe Allergic Reaction

Epinephrine auto-injectors are devices that contain epinephrine, a drug used to treat severe allergic reactions called anaphylaxis. They are available by prescription in a self-injectable device called epinephrine that automatically injects a measured dose of medicine.

Epinephrine auto-injectors are hand-held devices carried by those who have severe allergies. If a person has an epinephrine pen, he will generally understand how and when to use it. If you have been trained and your country and employer allow it, you may assist in administering the injection. Each epinephrine injector works differently. So, follow the instructions on the pen.

When anaphylaxis is suspected, an epinephrine solution should be administered as soon as possible as an intramuscular injection, in the middle of the outer side of the thigh. This injection can be given through the clothes or on bare skin.

Epinephrine pens are different for children and adults. As a result, make sure that you are using the correct prescribed device.

NOTE: Do not store the epinephrine auto-injector in a refrigerator or a hot car. Keep it at room temperature. The liquid medicine in the injector should be clear. If it is discolored or has floating specks, get a new injector. Check the expiration date. Tell the provider or nurse when you need a refill.

3. How to Use an Epinephrine Auto-Injector

3.1. Actions to use an Epinephrine Auto-Injector for a Severe Allergic Reaction

A severe allergic reaction can be life-threatening. Follow these steps to assist someone suffering from a severe allergic reaction in using his epinephrine pen:

  1. Make sure the scene is safe
  2. Shout for help
  3. Phone and alert EMS, get a first aid kit and an AED
  4. Ask if the person is allergic, what the cause of the allergy is, and check for any medical alert ID bracelet or necklace.
  5. The person getting the injection must be sitting or lying down during and after the injection.
  6. Form a fist around the auto-injector with the tip (safety cap) pointing down. Because the needle comes out of one end of the pen, make sure you're holding it without touching either end.
  7. Firmly hold the leg in place just before and during the injection. You can administer the injection through clothes or on bare skin.
  8. Pull off the safety cap.
  9. Place the tip of the injector against the fleshy portion of the outer thigh, approximately halfway between the hip and the knee.
  10. With a quick motion, press the auto-injector firmly against the thigh. This will release the needle that injects the dose of epinephrine.
  11. Hold the EpiPen and EpiPen Jr injectors in place for 3 seconds. Other injectors can be held in place for up to ten seconds. Make sure you're familiar with the manufacturer's instructions for the injector you're using.
  12. Remove the auto-injector from the thigh by pulling it straight out. Make sure that you don't put your fingers over the end that has been pressed against the person's thigh.
  13. Rub the injection spot for about 10 seconds (either the person getting the injection or the person giving the injection can do it).
  14. Replace the safety cap
  15. Note the time of the injection.
  16. If possible, save a sample of what caused the reaction.
  17. If the person does not improve after the first injection or if it takes more than 10 minutes for advanced help to arrive, consider giving a second dose, if available.
  18. Treat for shock (maintain body temperature).
  19. Quickly check for breathing if the person becomes unresponsive.
    1. If he is unresponsive and breathing normally, roll the person onto his side (recovery position).
    2. If he is unresponsive and is not breathing normally or only gasping, start CPR.
  20. Stay with the person, provide reassurance and monitor their condition until the ambulance arrives and medical professionals take over.

NOTE: People who have had a severe allergic reaction should wear a medical alert ID bracelet or necklace. You can get one at most pharmacies.

3.2. How to Dispose of the Epinephrine Auto-Injector Correctly

An epinephrine auto-injector device is a disposable single-use system. Use an Auto-Injector only once, then throw it away in a puncture-proof container (if available) or follow your company's sharps disposal policy. If you don't know what to do, hand over the device and the needle to the emergency medical professionals for proper disposal.

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If you wanna learn how to respond to anaphylactic shock amongst many other medical emergencies, you are welcome to join our American Heart Association® First Aid CPR AED course at our academy in Sukhumvit Bangkok. You will receive an international certification that is valid for 2 years. For more information about this course please click here or call us at 094 631 9679 or email us at

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