How to Treat Anaphylaxis
Anaphylaxis is a medical emergency. Fast action saves lives. If you think it might be anaphylaxis (even if you're unsure), treat right away with epinephrine. Do not treat with Benadryl or other antihistamines.
But first, a refresher on the definition of anaphylaxis (from my Allergies & Anaphylaxis 101 post):
Q: What is anaphylaxis?
A: Think A, B, C. If your child has Airway compromise (lip/tongue/throat swelling), Breathing difficulties, or Circulation collapse (low blood pressure or fainting, turning pale or blue), OR if a child is experiencing two or more symptoms (e.g. hives plus diarrhea or vomiting, or hives plus difficulty breathing), it is anaphylaxis. Even if each symptom seems mild (scratchy throat/tongue plus mild hives plus diarrhea), this is still considered anaphylaxis and needs to be treated quickly and aggressively. If in doubt, call it anaphylaxis and treat aggressively.
These 5 steps are based on another great infographic by Food Allergy Canada (see below). Note that these steps are identical in adults and children.
1️⃣ Give epinephrine — immediately
If the child has an epinephrine auto-injector (EpiPen Jr® or EpiPen® for children 50 kg and above), use it right away.
Do not wait.
It can be given through clothes or on bare skin. No need to clean the area.
The orange end always goes against the thigh.👉 Remember: “Orange to the thigh, blue to the sky.”
Have the child (or adult) lie down until the ambulance arrives.
2️⃣ Call 9-1-1
Tell them clearly: “Someone is having an anaphylactic reaction.”
3️⃣ Give a second dose if needed
If there is no improvement after 5 minutes, give a second auto-injector, if available.
4️⃣ Go to the hospital
Even if symptoms improve, the person needs medical monitoring in case symptoms of anaphylaxis return or worsen. Note, the reason for going to the hospital is the anaphylactic reaction, not because you gave epinephrine.
5️⃣ Call the emergency contact
Notify a parent, spouse, or other emergency contact as soon as possible.
❗ Important reminder
Antihistamines (like Benadryl®) are NOT a treatment for anaphylaxis.
They help with hives only and do not treat dangerous symptoms like breathing problems or low blood pressure.
Giving Benadryl instead of epinephrine is a common and serious mistake.
Bottom Line: If you are unsure whether to give epinephrine — GIVE IT. Epinephrine is very safe, and delaying it can be life-threatening. Don’t hesitate.
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