Diagnosis Demystified | Anaphylaxis Management | Edward Chew, MD

Anaphylaxis: What You Need to Know About This Life-Threatening Allergic Reaction

Anaphylaxis is a severe and potentially fatal allergic reaction that can strike within seconds or minutes of exposure to an allergen. It’s not just a bad rash or some sneezing—it’s a medical emergency that requires immediate treatment.

What Is Anaphylaxis?

Anaphylaxis occurs when your immune system overreacts to a typically harmless substance, such as peanuts, bee venom, or certain medications. Your body releases a surge of chemicals in response, which can send you into shock—suddenly dropping your blood pressure and narrowing your airways, making it hard to breathe.

Common Causes and Triggers

In children, foods like peanuts, milk, shellfish, and eggs are leading triggers. Adults often react to insect stings, latex, and medications such as antibiotics or NSAIDs. Even exercise, especially when combined with certain foods or weather conditions, can cause anaphylaxis in rare cases.

Recognizing the Symptoms

Symptoms usually start quickly but can sometimes be delayed. Watch for:

• Hives, itching, or pale skin

• Swelling of the face, tongue, or throat

• Wheezing or shortness of breath

• Nausea, vomiting, or diarrhea

• Dizziness, fainting, or a weak, rapid pulse

If you or someone else has these symptoms after exposure to a known allergen, don’t wait—get emergency help immediately.

What To Do in an Emergency

If you carry an epinephrine autoinjector (like an EpiPen), use it right away. Inject it into the outer thigh, through clothing if necessary. Afterward, always call 911—even if you feel better. Symptoms can come back in a second wave called biphasic anaphylaxis, and medical supervision is essential.

If someone else is experiencing anaphylaxis and doesn't have epinephrine, call 911 and help them lie down with legs elevated. Administer CPR if they stop breathing.

Diagnosing and Managing Anaphylaxis

After an attack, your provider may run blood tests or allergy tests to determine what caused the reaction. You may be referred to an allergist for ongoing management, especially if your trigger is unknown (idiopathic anaphylaxis).

Those with insect venom allergies may benefit from immunotherapy (allergy shots), which can reduce the risk of future reactions. Unfortunately, no such preventive treatment exists for most other allergens.

Prevention and Preparedness

To avoid future episodes:

• Stay away from known allergens.

• Read food labels carefully and ask about ingredients when dining out.

• Wear a medical alert bracelet or necklace.

• Keep your epinephrine autoinjector with you at all times, and replace it before it expires.

• Educate friends, family, and coworkers on how to use your autoinjector in case you can’t.

If your allergies are severe, speak to your healthcare provider about creating an emergency action plan.

Final Thoughts

Anaphylaxis is a frightening but manageable condition when treated quickly and taken seriously. Knowing your triggers, recognizing the signs, and carrying epinephrine can save your life or someone else’s. Never hesitate to seek emergency help—minutes can make all the difference.

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