Severe Allergic Reaction
Trouble breathing, swelling, or sudden rash after an exposure.
🚨 Call an ambulance immediately, then follow the steps below.
Step-by-step
- 1
Use their EpiPen if they have one
Press it firmly into the outer thigh (through clothing is fine). Hold for 3 seconds. Note the time. If symptoms don't improve within 5 minutes and a second pen is available, use it.
- 2
Call emergency services
Even if the EpiPen worked, they need hospital observation — a second wave ("biphasic reaction") can happen hours later.
- 3
Sit or lie them down
If they are struggling to breathe, sit them up. If they feel faint, lie them flat with legs raised. If pregnant, lie them on their left side. If vomiting, recovery position on their side.
- 4
Remove or avoid the trigger
If it's a bee sting, scrape the stinger out sideways with a card — don't pinch it (squeezes more venom in). If food, don't try to make them vomit.
- 5
Monitor breathing
Stay with them. If they become unresponsive and stop breathing normally, start CPR. Have the empty EpiPen ready to show paramedics.
🛑 Do NOT
- Do NOT let them stand up suddenly or walk around — sudden blood pressure drop can be fatal.
- Do NOT use antihistamines (Allergex, Phenergan) alone — they are NOT a substitute for adrenaline in anaphylaxis.
- Do NOT wait to see if it gets better — administer the EpiPen at the first sign of breathing difficulty or throat tightness.
- Do NOT skip the hospital visit even if symptoms resolve.
📞 Call an ambulance if…
- Any difficulty breathing, wheezing, or noisy breathing.
- Swelling of the tongue, lips, or throat.
- Sudden widespread rash with feeling unwell.
- Always — after any EpiPen use.
- Persistent vomiting or abdominal pain after a known trigger.
This guide is educational content — not medical advice. Always call emergency services first. Sources: Red Cross, American Heart Association, NHS England.