How to treat or cure anaphylaxis

How to Treat Anaphylaxis: The Only Sequence That Works

Treatment of anaphylaxis is one of the most protocolised acts in medicine, because the evidence is brutally consistent: early epinephrine saves lives, delay kills. Here is the sequence exactly as it should happen, per NHS guidance on anaphylaxis.

Step 1: The First 60 Seconds (You, Before Any Doctor)

1. Call emergency services immediately (India: 112 or 102). Say "anaphylaxis" - it prioritises the response
2. Inject epinephrine into the outer mid-thigh at the first sign of a severe reaction - through clothing if needed. Do not wait for "worse"
3. Position the person: lying flat with legs raised; semi-reclined if breathing is hard; on their side if unconscious and breathing; sitting up if pregnant
4. Remove the trigger if possible (stop the sting site exposure, spit out the food)

Step 2: While Help Comes

• If symptoms continue or worsen after 5-15 minutes, give the second epinephrine dose
• If the person stops breathing: begin CPR if you are trained
• Do not give anything by mouth - no water, no tablets - to someone with a compromised airway or consciousness
• Stay with them; note the time of each injection for the medics

Step 3: In the Ambulance and Hospital

• Oxygen, IV fluids, further epinephrine as needed, nebulisers for wheeze
• Antihistamines and steroids as support
• Observation for at least 6-12 hours - the biphasic second wave is the reason you stay even when you feel perfect

Step 4: After Discharge (This Is Part of Treatment)

• Prescription for two epinephrine auto-injectors and hands-on trainer practice
• Referral to an allergy specialist for trigger identification
• A written personal action plan; medical ID; training for family and school or workplace

What Treatment Is Not

• Not an antihistamine tablet and "let's see"
• Not a home remedy, oil, herbal preparation, or breathing exercise
• Not waiting for the rash to spread before acting

Anything that delays Step 1 is not a treatment choice - it is a risk.

Frequently Asked Questions

What if I am alone when anaphylaxis starts? Inject epinephrine first, then call emergency services, unlock the door, lie down with legs raised, and keep the phone with you. If alone with a second injector, keep it within reach.

Is epinephrine dangerous? What if I gave it and it wasn't anaphylaxis? Epinephrine in a mistaken situation may cause racing heart and tremor - unpleasant, rarely harmful. The evidence is unambiguous: the risk of withholding it in real anaphylaxis is far greater than the risk of giving it in error.

Can someone fully recover from anaphylaxis? Yes - with prompt treatment, the large majority recover completely. Recovery afterwards means specialist follow-up so it never catches you unprepared again.

Why do some people die despite reaching hospital? Almost always because epinephrine came too late or in inadequate doses early on. The first minutes belong to the people present - that is why everyone at risk carries the injector.