A definitive guide to the life-threatening allergic reaction that can occur by Simon Williams, Chief Executive of Anaphylaxis UK, a national allergy patient charity and partner to the BSACI.
Anaphylaxis (pronounced ana–fil-ax-is) is a serious and potentially life-threatening allergic reaction that requires immediate treatment. It usually starts within minutes of exposure to an allergen and can progress quickly, but in some cases, symptoms may be delayed by two to three hours. Anaphylaxis happens when the body’s immune system overreacts to something harmless, like a certain food, and treats it as a threat. These triggers are called allergens. In response, the immune system releases chemicals like histamine, which cause changes in the body that lead to allergic symptoms.
Anaphylaxis can happen to anyone, at any stage of life, even if they have never had a serious allergic reaction before. That’s why it’s essential to recognise the symptoms, know how to respond in an emergency, and take steps to manage the risks. Whether you’re visiting an allergy clinic for support or simply looking to learn more, being informed about the signs and symptoms of anaphylaxis could save a life. Anaphylaxis UK aims to empower individuals by providing clear, evidence-based information and resources that are accessible, credible and up-to-date. This guide will cover the symptoms of anaphylaxis, what to do in an emergency, and the emotional impact of living with serious allergies.
What triggers anaphylaxis
Anaphylaxis is usually triggered by an allergen. Foods are among the most common causes. In the UK, food businesses must highlight the top 14 food allergens on product labels, including foods like milk, eggs, tree nuts, peanuts, and shellfish. However, allergic reactions can also be caused by less common allergens, such as fruits and vegetables, and in some cases, even tiny traces of an allergen can trigger symptoms. Non-food triggers include insect stings (e.g. wasps or bees), latex, and certain medications.
In some cases, however, anaphylaxis may occur without any identifiable trigger, a condition known as idiopathic anaphylaxis.
Signs and symptoms of anaphylaxis
Anaphylaxis presents itself through a range of symptoms, often referred to as the ABC symptoms:
Airway – swelling in the throat, tongue, or upper airways (tightening of the throat, hoarse voice, difficulty swallowing).
Breathing – sudden onset wheezing, breathing difficulty, noisy breathing, persistent cough.
Circulation – dizziness, feeling faint, sudden sleepiness, tiredness, confusion, pale clammy skin, loss of consciousness.
The symptoms of anaphylaxis often progress rapidly. Therefore, recognising them early is vital to prevent the situation from becoming life-threatening. If you suspect you have an allergy, it’s important to discuss this with your GP who may refer you to an allergy specialist.
What to do in an emergency
In the event of a serious allergic reaction, time is critical. Here’s what you need to do:
1. Get in position:
- If the person is conscious, lie them flat with their legs raised to assist in blood flow to the heart and vital organs.
- If they’re having difficulty breathing, they can be propped up.
2. Administer an adrenaline auto-injector (AAI):
- If you or the person affected has been prescribed an AAI (such as an EpiPen or Jext), use it immediately. Adrenaline is the first-line treatment for anaphylaxis and should be administered as soon as symptoms arise.
- It’s crucial to carry two AAIs at all times, as one could misfire, or you may need a second dose if your symptoms worsen or don’t improve after five minutes.
3. Call 999
- Call emergency services immediately and say “Anaphylaxis” (ana-fil-ax-is). Give clear and precise instructions for your location. If you are outside, What3Words is a useful tool to pinpoint your exact location.
- Make a note of the time you administered the first dose of adrenaline. If symptoms don’t improve within five minutes, administer a second dose.
4. Do not move
- While waiting for the ambulance, do not move. Do not stand up even if you start to feel better. Standing up can exacerbate symptoms and lower your blood pressure drastically.
Medication
AAIs are designed to be quick and easy to use, even in high-stress situations. It is essential to follow the instructions specific to your device to ensure correct usage.
- You can practice using an AAI with trainer pens, which are available for free through the manufacturers’ websites. It’s a good idea to refresh your knowledge on how to use them.
- Be aware of the expiry date of your AAIs. Manufacturers offer an expiry alert service to help you keep track.
In some cases, however, anaphylaxis may occur without any identifiable trigger, a condition known as idiopathic anaphylaxis
Managing anaphylaxis: prevention and planning
There are steps you can take to reduce the risk of anaphylaxis and feel more in control:
1. Create an Allergy Action Plan
- Having a plan in place for anaphylaxis is crucial. This should include a list of known allergens, how to use your AAI, and emergency contact information. Discuss this plan with your family, friends, and those around you, including your school, workplace, and travel companions.
- Allergy Action Plans are available for download from BSACI. Complete with an allergy specialist or GP to help guide you in the event of a reaction.
2. Work with an allergy specialist:
- For those at risk, working with an allergy specialist can help identify triggers, recommend treatments like immunotherapy, and discuss long-term management strategies.
3. Be allergy wise in different settings:
- Different environments will have varying levels of awareness and preparedness when it comes to allergies. For example, schools, restaurants, and holiday clubs may have specific procedures for handling allergies, while other settings may not.
Anaphylaxis UK provides guidance on what to do in different settings, so be sure to review the information on our website when planning activities.
Different environments will have varying levels of awareness and preparedness when it comes to allergies.
Creating a safer environment
There are also ways in which you can raise awareness and advocate for people with allergies in the everyday world. As well as discussing your allergies, you can also encourage education establishments and childcare businesses to enhance their allergy protocols, ensuring a safer environment for everyone affected by allergies.
Anaphylaxis UK hosts a range of comprehensive AllergyWise® allergy and anaphylaxis courses for those working with or caring for children and young people, including early years, schools, clubs and workplaces. Find out more on our website.
The hidden battle with allergies
While the physical symptoms of anaphylaxis are well-known, the emotional burden can be just as significant. Anxiety about the potential for a life-threatening reaction can lead to individuals avoiding social situations, and it may cause ongoing stress for families and loved ones. Anaphylaxis UK recognises this hidden battle and is committed to raising awareness and offering support. We’re developing new resources and support services to help tackle allergy-related anxiety. Take a look at our website for more information or contact our helpline team on 01252 542029 between the hours of 9am-5pm, Monday to Friday.
Fundraise for Anaphylaxis UK
As we continue to raise awareness, develop new resources, and support those affected by anaphylaxis, we rely heavily on the generosity of our supporters. Through donations and fundraising efforts, we can continue to offer free resources, training, and a wide range of support services.
To find out more about our fundraising efforts and how you can contribute, please visit our website at www.anaphylaxis.org.uk. Every contribution, big or small, helps make a significant difference in the lives of those living with serious allergies.
Thank you for your ongoing support. Together, we can create a safer, more informed environment for people at risk of anaphylaxis.
Simon Williams
Chief Executive
Simon has been a driving force behind the modernisation and expansion of Anaphylaxis UK. His leadership has not only transitioned the organisation but has also fostered a more collaborative culture. By introducing new services and innovative strategies, Simon has significantly extended the charity’s reach, enabling it to help more people affected by anaphylaxis. With a vision to grow the charity even further, Simon’s impactful and modernising leadership promises to continue making a lasting difference in the lives of those the charity serves. Anaphylaxis UK (formerly Anaphylaxis Campaign prior to July 2022) has been supporting people living with serious allergies as a charity for 30 years, offering evidence-based information for individuals and their families, for businesses and for schools and other places of education, with the ultimate aim of creating a brighter future for people with serious allergies.
