Anaphylaxis Anaphylaxis

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Dr Alyson Kakakios
Consultant Paediatric Immunologist
Head, Department of Allergy and Immunology
The Children’s Hospital at Westmead
NSW Australia

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What is anaphylaxis?

Anaphylaxis is a potentially life-threatening allergic reaction due to the effects on the breathing system and the heart. It should always be treated as a medical emergency. This requires early recognition of symptoms and familiarity with the emergency treatment.

Anaphylaxis is the most severe form of allergic reaction. Common causes of anaphylaxis are:

  • food (most commonly peanuts, tree nuts, milk, egg, sesame and seafood)

  • insect stings (commonly bees, wasps and ants), as well as

  • some medications. (antibiotics and anti-inflammatory drugs)

photograph of peanuts in a sheel

Fig 1: Peanuts in shells

Whether it's peanuts, pets or pollen, allergies are on the rise.

video icon Look at the video Allergies from School parents: Helping Mums and Dads with school life to learn more.

A mild to moderate allergic reaction may include some or all of the following symptoms:

  • swelling of lips, face and eyes

  • hives or welts

  • abdominal pain, nausea, vomiting, tingling mouth.

A severe allergic reaction (anaphylaxis) may include one or more of the following symptoms:

  • difficult/noisy breathing

  • swelling of tongue

  • swelling/tightness in the throat

  • difficulty talking and/or a hoarse voice

  • wheeze or persistent cough

  • loss of consciousness and/or collapse

  • pallor and floppiness (in young children).

Emergency treatment of anaphylaxis at school

  • Administer the student’s adrenaline autoinjector (eg EpiPen or EpiPen Junior or Anapen or Anapen Junior). If it is suspected that a person is having an acute allergic reaction, not giving the adrenaline autoinjector can be more harmful than giving it when it may not have been necessary.

  • Call an ambulance. Telephone 000.

  • Signs of improvement should be seen rapidly, usually within a few minutes. If there is no improvement, or symptoms are getting worse, then a second autoinjector may be administered after 5–10 minutes if available.

  • If possible, lie the student flat and elevate legs. If breathing is difficult however, allow to sit but not to stand.

  • Contact a parent or carer.