Treatment of Anaphylaxis

Publication Date: February 2, 2022

Last Updated: March 3, 2023

Objective

This patient summary means to discuss key recommendations from the Wilderness Medical Society for managing anaphylaxis.

Overview

Anaphylaxis is a severe allergic reaction that can be life-threatening.
Some of the most common allergens (causes of anaphylaxis) are bee stings, peanuts, tree nuts, certain foods and pollen.
Symptoms include sudden itchy rashes, low blood pressure, difficult breathing, nausea, vomiting, diarrhea, abdominal pain, heart pounding, fainting and confusion.
This patient summary focuses on non-medical persons treating anaphylaxis in a setting remote from medical care.

Treatment

Immediate injection of epinephrine into a muscle is critical.
- Preferred sites are the outside-front of the thigh or the deltoid (shoulder).
- Prefilled syringes are an excellent method.
Epinephrine may be repeated every 5-15 minutes.
Separating the patient from the allergen is important, but do not induce vomiting.
For continued relief, you may also use anti-histamines, cortisone or, for wheezing, a certain kind of asthma inhaler (beta-agonist).
Everyone planning to spend time with groups in remote locations should have basic training in managing anaphylaxis and carry epinephrine.
Secondary care for prolonged anaphylaxis is sometimes necessary, so continued observation and plans for emergency evacuation should be in place.

Source Citation

Gaudio FG, Johnson DE, DiLorenzo K, Anderson A, Musi M, Schimelpfenig T, Leemon D, Blair-Smith C, Lemery J. Wilderness Medical Society Clinical Practice Guidelines on Anaphylaxis. Wilderness Environ Med. 2022 Mar;33(1):75-91. doi: 10.1016/j.wem.2021.11.009. Epub 2022 Feb 2. PMID: 35120856.

Disclaimer

The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.