Diagnosis

Your doctor will ask you questions about previous allergic reactions, including whether you've reacted to:

  • Particular foods
  • Medications
  • Latex
  • Insect stings

To help confirm the diagnosis:

  • You might be given a blood test to measure the amount of a certain enzyme (tryptase) that can be elevated up to three hours after anaphylaxis
  • You might be tested for allergies with skin tests or blood tests to help determine your trigger

Many conditions have signs and symptoms similar to those of anaphylaxis. Your doctor will want to rule out other conditions.

Treatment

During an anaphylactic attack, you might receive cardiopulmonary resuscitation (CPR) if you stop breathing or your heart stops beating. You might also be given medications, including:

  • Epinephrine (adrenaline) to reduce your body's allergic response
  • Oxygen, to help you breathe
  • Intravenous (IV) antihistamines and cortisone to reduce inflammation of your air passages and improve breathing
  • A beta-agonist (such as albuterol) to relieve breathing symptoms

What to do in an emergency

If you're with someone who's having an allergic reaction and shows signs of shock, act fast. Look for pale, cool and clammy skin; a weak, rapid pulse; trouble breathing; confusion; and loss of consciousness. Do the following immediately:

  • Call 911 or emergency medical help.
  • Use an epinephrine autoinjector, if available, by pressing it into the person's thigh.
  • Make sure the person is lying down and elevate his or her legs.
  • Check the person's pulse and breathing and, if necessary, administer CPR or other first-aid measures.

Using an autoinjector

Many people at risk of anaphylaxis carry an autoinjector. This device is a combined syringe and concealed needle that injects a single dose of medication when pressed against the thigh. Always replace epinephrine before its expiration date, or it might not work properly.

Using an autoinjector immediately can keep anaphylaxis from worsening and could save your life. Be sure you know how to use the autoinjector. Also, make sure the people closest to you know how to use it.

Long-term treatment

If insect stings trigger your anaphylactic reaction, a series of allergy shots (immunotherapy) might reduce your body's allergic response and prevent a severe reaction in the future.

Unfortunately, in most other cases there's no way to treat the underlying immune system condition that can lead to anaphylaxis. But you can take steps to prevent a future attack — and be prepared if one occurs.

  • Try to avoid your allergy triggers.
  • Carry self-administered epinephrine. During an anaphylactic attack, you can give yourself the drug using an autoinjector (EpiPen, others).

Coping and support

Having a potentially life-threatening reaction is frightening, whether it happens to you, others close to you or your child. Developing an anaphylaxis emergency action plan can help put your mind at ease.

Work with your own or your child's doctor to develop this written, step-by-step plan of what to do in the event of a reaction. Then share your plan with teachers, baby sitters and other caregivers.

If your child has a severe allergy or has had anaphylaxis, talk to the school nurse and teachers to find out what plans they have for dealing with an emergency. Make sure school officials have a current autoinjector.

Feb. 14, 2017
References
  1. Campbell RL, et al. Anaphylaxis: Acute diagnosis. http://www.uptodate.com/home. Accessed Nov. 20, 2016.
  2. Anaphylaxis. American Academy of Allergy Asthma & Immunology. http://www.aaaai.org/conditions-and-treatments/allergies/anaphylaxis. Accessed Nov. 20, 2016.
  3. Anaphylaxis. American College of Allergy, Asthma and Immunology. http://acaai.org/allergies/anaphylaxis. Accessed Nov. 20, 2016.
  4. Fromer L. Prevention of anaphylaxis: The role of the epinephrine auto-injector. The American Journal of Medicine. 2016;139:1244.
  5. Swan KE, et al. The prevention and management of anaphylaxis. Paediatrics and Child Health. 2016;26:279.
  6. Irani AM, et al. Management and prevention of anaphylaxis. F1000 Research. 2015;4:1492.