**Anaphylaxis – Severe Allergic Reaction (7762) – reviewed Nov 2025 – added 2nd dose in opposite leg

Signs and Symptoms of Anaphylaxis

• Blotchy skin rash (hives) or flushing
• Sense of impending doom
• Swelling of the tongue and/or throat and mouth
• Difficulty in swallowing or speaking
• Vocal changes (hoarse voice)
• Wheeze or persistent cough or severe asthma
• Difficult or noisy breathing
• Stomach cramps or vomiting after an insect sting
• Sudden feeling of weakness (drop in blood pressure)
• Dizziness / collapse / loss of consciousness

NOTE: A patient would not necessarily experience all of these symptoms in the same episode

Treatment of Anaphylaxis

Remember to stay as calm as possible so that you can reassure the casualty:

• Call 999 OR 112 for an ambulance
• Check whether the casualty is carrying an adrenaline auto-injector (AAI) or Neffy nasal spray. Assist them to use it, if necessary
• If the casualty is unable to administer the medication themselves you can administer it to them.
• The casualty should be lying down and remain as still as possible
• Raise their legs if they feel dizzy or faint or appear pale and sweating
• Raise their shoulders if they feel wheezy or short of breath
• If the casualty becomes unconscious, check Airway and Breathing and start CPR if necessary
• If the casualty has more than one auto-injector, the dose of adrenaline can be repeated at 5 minute intervals if there is no improvement
• Ideally, give the second dose in the opposite leg

Important: DO NOT sit the casualty up once they are lying down