Correct Treatment of Anaphylaxis in the Workplace or Home: A First Aid Trainer’s Guide

Anaphylaxis is a severe, life-threatening allergic reaction that can escalate within minutes, leading to airway obstruction, respiratory failure, or cardiac arrest. Common triggers include foods (e.g., nuts, shellfish), insect stings, medications, and latex. Immediate intervention is critical to save lives. Here’s how to recognize and treat anaphylaxis effectively in any setting.

1. Recognize the Symptoms

Anaphylaxis often involves multiple body systems. Use the ABC (Airway, Breathing, Circulation, Disability, Exposure) approach to identify signs:

• Airway/Throat: Swelling of the lips, tongue, or throat; hoarse voice; difficulty swallowing.
• Breathing: Wheezing, coughing, shortness of breath, or chest tightness.
• Circulation/Skin: Pale or flushed skin, hives, rapid/weak pulse, dizziness, or fainting.
• Gastrointestinal: Nausea, vomiting, or diarrhea.
• Neurological: Confusion, agitation, or loss of consciousness.

Note: Symptoms can progress rapidly. Even mild signs (e.g., hives) can quickly become severe.

2. Immediate First Aid Steps

A. Administer Epinephrine (Priority Action)

• Use an epinephrine auto-injector (EpiPen, Auvi-Q):
  1. Remove the safety cap.
  2. Hold the injector firmly against the outer thigh (midway between hip and knee).
  3. Push down until it clicks; hold for 3–10 seconds (follow device instructions).
  4. Massage the injection site for 10 seconds.
• Repeat after 5–15 minutes if symptoms persist or worsen.

B. Call Emergency Services (000 or Local Emergency Number)

• Even if symptoms improve, anaphylaxis can recur (biphasic reaction). Professional medical care is essential.

C. Position the Person

• Lying down with legs elevated (unless breathing is severely impaired, in which case keep them seated).
• If vomiting or unconscious, place in the recovery position.

D. Monitor and Support

• Loosen tight clothing and reassure the person.
• If breathing stops, begin CPR.

E. Use Additional Medications (If Available)

• Antihistamines (e.g., Benadryl): Administer after epinephrine to reduce hives or itching (do NOT substitute for epinephrine).
• Inhalers (e.g., albuterol): Use for persistent wheezing.

3. What NOT to Do

• Do not delay epinephrine—waiting worsens outcomes.
• Do not let the person stand or walk—this can trigger cardiac arrest.
• Avoid oral foods/drinks if throat swelling is present.

4. Post-Emergency Care

• The person must go to the hospital for 4–6 hours of observation, even if symptoms resolve.
• Provide responders with details: trigger (if known), time of exposure, and medications administered.

5. Prevention and Preparedness

• Avoid allergens: Label food in shared spaces; keep workspaces free of insect nests.
• Emergency action plan: Individuals with known allergies should share their plan, including:
  • Location of epinephrine auto-injectors.
  • Emergency contacts.
• Stock epinephrine: Keep auto-injectors in first aid kits (check expiration dates monthly).
• Train staff/family: Practice using trainer injectors and recognize early symptoms.

Why Epinephrine Saves Lives

Epinephrine reverses anaphylaxis by constricting blood vessels, opening airways, and stabilizing blood pressure. Delaying its use increases the risk of fatal complications.

Special Considerations

• Children: Use pediatric-dose auto-injectors (e.g., EpiPen Jr).
• Unknown triggers: If the cause is unclear, treat symptoms as anaphylaxis and seek help.
• Legal protections: Good Samaritan laws protect those assisting in good faith.

Final Thoughts

Anaphylaxis demands swift, confident action. Equip workplaces and homes with epinephrine, ensure teams are trained, and foster a culture of vigilance. Remember: Always use epinephrine first, call 000, and never downplay allergic reactions.

By prioritizing preparedness, you empower bystanders to act decisively and save lives.

Note: Aligns with guidelines from the American Academy of Allergy, Asthma & Immunology (AAAAI) and Red Cross. Regular drills using trainer injectors build muscle memory and confidence.