Anaphylaxis explained

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Every year, thousands of Australians are hospitalised for anaphylaxis, often as a result of food allergies.

With one in 20 children and about one in 50 adults suffering from food allergies, worrying about having a severe, and possibly fatal, reaction to something you’ve eaten is a very real concern for many Australians.

So what exactly is anaphylaxis and what can you do to stop it? First Aid Course can help.

What is anaphylaxis?

Anaphalaxis is the most severe form of allergic reaction a person can have.


Mild/moderate allergic reaction:

  • Swelling of lips, face, eyes
  • Hives or welts
  • Tingling mouth
  • Abdominal pain


  • Difficulty/noisy breathing
  • Swelling of the tongue
  • Swelling/tightness of throat
  • Difficulty talking/hoarse voice
  • Wheeze or persistent fault
  • Persistent dizziness or collapse
  • Pale and floppy (young children)

Source: Australasian Society of Clinical Immunology and Allergy(ASCIA)

“It’s an immune system reaction,” Maria Said, from Allergy and Anaphylaxis Australia, said.

“So a person has an antibody to a particular food protein and when they eat that food their body has a reaction. It’s multi-system reaction often.”

The difference between an allergic reaction and anaphylaxis is the latter involves the respiratoryand/or cardiovascular system.

“People who have an allergic reaction often have skin symptoms, so they might have a rash, they might have some swelling of the face, the lips or the eyes,” Ms Said said.

Once it involves their breathing and/or their heart, the situation becomes dangerous and life-threatening.

“If the person has any breathing difficulties — they have persistent coughing or wheezing, they complain of throat tightness or they have a change in their voice — that’s all to do with the respiratory system,” Ms Said said.

“Or if the person becomes really pale and listless, they become really dizzy, that’s a sign that the cardiovascular system is involved.

“Any of those symptoms and you’ve got to act very quickly.”

Can you ride it out?

How to use an EpiPen:

  • Hold it in your fist, keeping your fingers and thumb away from the ends
  • Hold it with the “blue to the sky, orange to the thigh”
  • Pull the blue end off — it’s a safety release
  • Place the orange end between the knee and the hip on the outer thigh
  • You can use it through clothing, but avoid pockets
  • Push until you hear a click then hold if for three seconds before releasing
  • Keep the person laying down until an ambulance arrives (standing will cause their blood pressure to drop)

According to Ms Said, if someone has an anaphylaxis then the only thing that will reverse it is a shot of adrenaline.

“Adrenaline is a natural hormone that’s in our body but when we have an anaphylaxis, we don’t have enough adrenaline to reverse the signs and symptoms,” she said.

“So it’s critical that that person gets an EpiPen — which is the only auto-injector that we have containing adrenaline in Australia — it’s critical that’s injected promptly to save someone’s life.”

It is possible to survive anaphylaxis without a shot of adrenaline, but it’s a dangerous gamble.

“There are times when people have had an anaphylaxis and they have not administered adrenaline and they’ve been lucky that it has self-limited,” Ms Said said.

“But more times a person will need adrenaline. An anaphylaxis is unpredictable, you don’t know when it’s going to stop at that point or where it’s going to keep going.”

Adolescents are more likely to die from anaphylaxis if they also have asthma, as symptoms of the former can be mistaken for the latter, meaning people they are given a puffer instead of an EpiPen.

Because there is no register in Australia of deaths as a result of anaphylaxis, it’s hard to get a handle on how many people have actually died from it here.

In 2016, researchers led by Dr Raymond Mullins examined coronial records and data from the Australian Bureau of Statistics (ABS).

The study found that the ABS had recorded 324 anaphylactic deaths between 1997 and 2013, and that the number of deaths had increased over time.

But researchers say this figure is likely an under-estimation of the real number of fatal cases of anaphylaxis.

Learn more about treatment in a First Aid Course.

What causes anaphylaxis?

Dr Mullins study found that of the deaths recorded by the ABS most of those deaths were due to reactions to medication, followed by reactions to insect stings and bites, and food.

But a severe allergic reaction to food — particularly nuts — is more likely to kill young people and death from food-related anaphylaxis is rare.

Nuts (peanuts and tree nuts) are behind the majority of food-related anaphylactic deaths for people under 20 years old, but the ABS data actually showed more people overall die from attacks brought on by seafood.

Ms Said said there are ten foods that trigger 90 per cent of food-related allergic reactions in Australia.

Those foods are:

While people are more likely to suffer anaphylaxis outside the home, Ms Said said restricting the sale of such foods would be a bit over the top.

“That’s too much to ask for, these are nutritious foods. It’s just about people understanding the risk,” she said.

“Instead of using the one utensil to use all the salads in one night in a cafe, a clean bowl and clean utensils are used and people wash their hands between salads.”

Make sure you attend a first aid course before summer so you are prepared. Book in now and receive a free first aid manual and cpr first aid mask.

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