An Anaphylaxis emergency protocol is essential for managing this severe, potentially life-threatening allergic reaction that requires immediate recognition and emergency treatment. Common triggers include food, medication, and insect stings.
The Australasian Society of Clinical Immunology and Allergy (ASCIA) provides updated anaphylaxis guidelines to help people at risk of anaphylaxis and health professionals working in emergency departments. This protocol outlines the severity of anaphylaxis, symptoms, emergency care procedures, and preventive strategies to minimise the risk of severe allergic reactions.
Recognising Anaphylaxis: Symptoms of a Severe Allergic Reaction
Symptoms of anaphylaxis often develop rapidly and may affect multiple body systems. The onset of symptoms can vary from person to person:
- Respiratory: Difficulty breathing, wheezing, persistent cough, throat tightness (particularly concerning for someone with known asthma and allergy)
- Cardiovascular: Dizziness, fainting, rapid heartbeat, low blood pressure
- Skin symptoms: Widespread hives, flushing, swelling (especially angioedema of lips, face, tongue, and eye area)
- Gastrointestinal symptoms: Abdominal pain, vomiting, diarrhoea, nausea, sickness
- Neurological: Anxiety, confusion, sense of impending doom
It’s important to note that not all symptoms may be present during an episode, and respiratory or cardiovascular symptoms are particularly concerning indicators of severe anaphylaxis.
Anaphylaxis Emergency Protocol: Management and Emergency Treatment for Severe Allergic Reaction
The acute management of anaphylaxis requires prompt action:
- Position the person flat on their back with legs elevated (unless breathing is difficult)
- Administer adrenaline via an adrenaline injector (such as an EpiPen) into the outer mid-thigh – adrenaline is the first line treatment for anaphylaxis and should never face delay
- Call emergency services (000) immediately after using an adrenaline autoinjector if available
- Monitor the person continuously for changes in condition
- Administer a second dose of adrenaline after 5-15 minutes if symptoms persist – appropriate adrenaline doses depend on age and weight
- Provide emergency care until paramedics arrive
For severe anaphylaxis that doesn’t respond to initial treatment, health professionals may use IV adrenaline infusion or an adrenaline ampoule and syringe in emergency departments. Antihistamines may help with skin symptoms but are not a first line treatment for anaphylaxis.
ASCIA Action Plan: Planning for Asthma and Allergy Attacks
The ASCIA Action Plan for Anaphylaxis provides a standardised approach to emergency treatment of anaphylaxis:
- Personal Action Plans: Each person prescribed an adrenaline injector should have an individualised ASCIA Action Plan detailing their allergy to food, medication or insect venom
- General Use Action Plans: For situations where anaphylaxis occurs in someone without a known history
- Dual Diagnosis Management: Special considerations for someone with known asthma who may also experience anaphylaxis
- Regular Review: A child’s ASCIA Action Plan should be updated annually with their medical practitioner
ASCIA Action Plans and first aid plans for anaphylaxis should be prominently displayed in relevant locations. The ASCIA website offers downloadable plans and other anaphylaxis resources for individuals and organisations.
Preventive Strategies to Minimise Allergen Exposure
To reduce anaphylaxis emergencies in Australian workplaces and schools, implement preventive strategies based on anaphylaxis guidance 2020 from the World Allergy Organization and Academy of Allergy.
Conduct thorough assessments to identify potential triggers such as food allergens, medications, and insects that may sting. Certain workplaces report higher rates of severe allergic reactions due to occupational exposure. Implement protective measures including proper technique for handling potential allergens and create policies to prevent accidental exposure. Establish strict cleaning practices to prevent cross-contamination.
- Develop clear allergen management policies including proper labelling of food products or treatment described on the website
- Allow flexible arrangements for employees with severe allergy to minimise their exposure
- Provide staff with medical training on anaphylaxis emergency protocols
- Ensure access to adrenaline injector devices in first aid kits
- Regularly review and update management plans to maintain compliance with ASCIA guidelines
- Conduct practice sessions on the correct administration of adrenaline using trainer devices
Employer Responsibilities for Managing Anaphylaxis Risks
Implement anaphylaxis-specific first aid training for all employees
Equip your team with life-saving skills through comprehensive training on anaphylaxis used in emergency care settings.
- Conduct annual refresher courses using training devices to practise adrenaline autoinjector technique
- Develop recognition of symptoms that may indicate anaphylaxis through demonstrations
- Emphasise proper positioning and administration of adrenaline for someone experiencing severe reaction
- Promote allergen control to prevent duplicate entry of allergens into workspaces
Conduct workplace risk assessments
- Identify potential sources of food, medication, and insect exposure
- Eliminate or replace known triggers where possible
- Maintain clean environments to prevent serum levels of allergens from building up
- Designate allergen-restricted zones where appropriate
Develop anaphylaxis-specific emergency response plans
- Ensure accessible storage of employees’ prescribed adrenaline injectors
- Maintain general-use adrenaline autoinjectors for emergency treatment of anaphylaxis
- Coordinate team roles when responding to anaphylaxis
- Contact emergency departments immediately after administering adrenaline
Ensure workplace safety, compliance, and emergency preparedness
- Adhere to relevant Australian health and safety regulations
- Regularly review the product or treatment described in anaphylaxis plans
- Communicate risks and emergency protocols to all staff
- Collaborate with local health professionals working in emergency services
Frequently Asked Questions
What is the difference between a mild allergic reaction and anaphylaxis?
Mild reactions typically affect only skin symptoms and respond to antihistamines. Anaphylaxis affects multiple systems simultaneously and requires immediate adrenaline as the first line treatment.
How long should someone be monitored after an anaphylactic reaction?
Health professionals recommend observation for at least 4-6 hours after initial symptoms resolve, as some people may experience a second wave of symptoms.
Can someone experience anaphylaxis without previous allergic reactions?
Yes. Approximately 25% of severe anaphylaxis cases occur in individuals with no prior history of allergic reactions to the triggering substance.
