Anaphylaxis first aid requires fast recognition, immediate adrenaline and an urgent call to Triple Zero (000). A severe allergic reaction can affect breathing, the airway or circulation within minutes. Whether it happens at home, at school or in a Melbourne workplace, knowing how to recognise anaphylaxis and use an adrenaline device such as an EpiPen® or Anapen® can make a critical difference.
Anaphylaxis is a medical emergency. The Australasian Society of Clinical Immunology and Allergy (ASCIA) identifies adrenaline, also called epinephrine, as the first-line treatment. Importantly, you do not need to wait for every possible symptom to appear. Any one recognised sign of anaphylaxis is enough to act.
5 Key Takeaways
- Adrenaline is the first-line treatment for anaphylaxis and should be given without delay.
- Anaphylaxis can occur without hives, redness or other obvious skin symptoms.
- A person experiencing anaphylaxis should not stand or walk.
- EpiPen® and Anapen® both deliver adrenaline, but they are operated differently.
- After giving adrenaline, call Triple Zero (000). Further adrenaline may be given if there is no response after five minutes.
What Is Anaphylaxis?
Anaphylaxis is the most severe form of allergic reaction. It can develop rapidly and become life-threatening because it may interfere with a person’s airway, breathing or circulation.
Common triggers include foods, insect stings and medications, although anaphylaxis can have other causes. A person may already know they have a severe allergy and carry an adrenaline device and ASCIA Action Plan. In other cases, the reaction may be unexpected.
This is why anaphylaxis awareness matters beyond households with a known allergy. Teachers, childcare workers, colleagues, supervisors, sports coaches and members of the public can all potentially find themselves responding to an allergic emergency.
ANZCOR advises that anaphylaxis requires immediate treatment and urgent medical attention. Adrenaline given by intramuscular injection is the first-line drug treatment for life-threatening anaphylaxis.
How Do You Recognise Anaphylaxis?
One of the most dangerous misconceptions about anaphylaxis is that the person must develop a rash.
They do not.
ASCIA advises watching for any one of the recognised signs of anaphylaxis. These include difficult or noisy breathing, swelling of the tongue, swelling or tightness in the throat, wheezing or persistent coughing, difficulty talking or a hoarse voice, persistent dizziness or collapse, and a young child becoming pale and floppy.
Abdominal pain and vomiting are also considered signs of anaphylaxis in the case of insect allergy.
A mild to moderate allergic reaction can look different. Someone may develop hives or welts, swelling around the lips, face or eyes, or tingling in the mouth.
These symptoms still need attention and monitoring because a reaction can progress. However, once signs of anaphylaxis appear, adrenaline becomes the priority.
Why Is Adrenaline Used for Anaphylaxis?
Adrenaline — also known as epinephrine — works rapidly against the potentially life-threatening effects of anaphylaxis.
It can assist breathing, support heart function and improve blood pressure. ASCIA states that it works within minutes and that adrenaline devices are designed so they can be used by people without medical training.
This is an important distinction because other medicines should not be regarded as substitutes for adrenaline during anaphylaxis.
For example, someone experiencing anaphylaxis may also have asthma. ASCIA’s first aid guidance is clear that when there is severe and sudden breathing difficulty, including wheeze, persistent cough or a hoarse voice, give the adrenaline device first, then seek medical assistance.
When anaphylaxis is suspected, delaying adrenaline while waiting to see whether the person gets worse can lose valuable time.
What Should You Do When Someone Has Anaphylaxis?
Positioning the casualty correctly is an essential part of anaphylaxis first aid.
Lay the person flat and do not allow them to stand or walk. If breathing is difficult, they may sit with their legs outstretched. If they are unconscious, place them in the recovery position. A pregnant casualty who needs the recovery position should be placed on their left side.
Young children should be held flat rather than upright.
Then:
- Give an adrenaline device without delay.
- Phone Triple Zero (000) for an ambulance.
- Contact the person’s family or emergency contact where appropriate.
- If there is no response after five minutes, further adrenaline may be given.
- Continue monitoring the person until emergency help arrives.
If the casualty becomes unresponsive and is not breathing normally, commence CPR. ASCIA also advises that a person treated for anaphylaxis should be transferred to hospital for at least four hours of observation.
How Do You Use an EpiPen?
An EpiPen® is a single-dose adrenaline autoinjector designed for emergency treatment of anaphylaxis.
ASCIA’s current instructions are straightforward:
- Form a fist around the EpiPen® and pull off the blue safety release.
- Hold the person’s leg still and place the orange end against the outer mid-thigh. It can be administered with or without clothing.
- Push down firmly until you hear or feel a click and hold for three seconds, then remove the EpiPen®.
The used EpiPen® should be given to ambulance personnel, along with the time at which it was administered.
The outer mid-thigh is important. An adrenaline injector should not simply be pressed against whichever part of the leg is easiest to reach.
First aid training also helps take some of the uncertainty out of an emergency. Reading instructions is useful; physically practising the sequence with a training device makes it much easier to understand how the procedure works before somebody’s life depends on it.
What About Anapen?
Anapen® is also an adrenaline injector, but it does not operate in exactly the same way as an EpiPen®.
For Anapen®, ASCIA’s instructions are to remove the needle shield, remove the grey safety cap from the red button, place the needle end firmly against the outer mid-thigh at a 90-degree angle, and then press the red button until it clicks. Hold it in position for three seconds before removing it.
After use, the exposed needle needs to be treated carefully. The used device should ultimately be provided to ambulance personnel with the time the adrenaline was administered.
This difference between devices is precisely why familiarity matters. Someone who has only learnt to recognise the word “EpiPen” may hesitate when presented with a different adrenaline device.
There has also been a significant change in the Australian market. As of ASCIA’s July 2026 information, approved adrenaline devices include EpiPen®, Anapen®, Jext® and the neffy® adrenaline nasal spray. ASCIA currently reports that Anapen® 500 is out of stock in Australia, while Anapen® Junior 150 and Anapen® 300 are no longer available.
People prescribed an adrenaline device should follow their current ASCIA Action Plan and be familiar with the particular device they have been prescribed.
The activation steps may seem similar when you read them calmly, but they are not interchangeable. During anaphylaxis, even a short delay can matter.
Anaphylaxis at Home
For families managing a diagnosed severe allergy, preparedness means more than knowing where the adrenaline device is kept.
Parents, carers and older children should understand the person’s ASCIA Action Plan, know where prescribed adrenaline devices are stored and check expiry dates. Other people who regularly care for the child may also need to know how to recognise anaphylaxis and access the device quickly.
It is equally important not to let a person who has received adrenaline simply get up because they say they feel better. ASCIA warns against standing or walking during anaphylaxis because blood pressure can fall rapidly.
Anaphylaxis at School or Childcare
Food allergies and other allergy risks make anaphylaxis preparedness particularly important in education and care environments.
Staff may need to recognise a reaction, locate the child’s ASCIA Action Plan and prescribed adrenaline device, administer adrenaline and coordinate the Triple Zero (000) call while supervising other children.
There may also be situations involving a child without a previously diagnosed allergy.
ASCIA specifically recommends adrenaline devices rather than ampoules, needles and syringes for non-medical settings such as schools, children’s education and care services and workplaces. The devices provide a fixed dose and are designed for use by people without medical training.
Anaphylaxis in the Workplace
Anaphylaxis can occur almost anywhere: an office lunchroom, construction site, warehouse, café, outdoor worksite or staff function.
A colleague may have a known food allergy. A worker outdoors may react severely to an insect sting. Someone may experience an unexpected reaction to a substance or medication.
Workplace first aid preparation should therefore consider whether first aiders know how to recognise anaphylaxis, where first aid equipment is located, how emergency services will be contacted and how an ambulance will reach the casualty quickly.
Having equipment available is valuable. Having people who can recognise what is happening and act confidently is better.
A recognised First Aid course with First Aid Pro Melbourne gives participants an opportunity to develop practical emergency response skills, including responding to allergic reactions and anaphylaxis. Those skills can be useful in the workplace, at home and anywhere else a medical emergency occurs.
Don't Wait for the Reaction to “Look Serious Enough”
Anaphylaxis can deteriorate rapidly, and skin symptoms are not required for it to occur.
That is why ASCIA’s first aid message is deliberately decisive: if in doubt, give the adrenaline device.
Once anaphylaxis is recognised, focus on the priorities: appropriate positioning, adrenaline, Triple Zero (000), continued observation and further adrenaline if there is no response after five minutes.
Knowing those actions beforehand is far easier than trying to learn them while somebody is struggling to breathe.
First aid training cannot prevent an allergic reaction, but it can help prepare you to recognise an emergency and respond when time matters. To build practical skills for emergencies at home or work, consider completing a recognised First Aid course with First Aid Pro Melbourne.
Related Reading
ASCIA – ASCIA Action Plans and First Aid Plan for Anaphylaxis
Allergy and Anaphylaxis Australia – Adrenaline Hub
First Aid Pro – 5 Critical Anaphylaxis First Aid Steps: Use an EpiPen
Allergy and Anaphylaxis Australia – neffy
FAQs
What is the first-line treatment for anaphylaxis?
Adrenaline (epinephrine) is the first-line treatment for anaphylaxis. It should be administered without delay when anaphylaxis is suspected, followed by an urgent call to Triple Zero (000).
Can you have anaphylaxis without hives?
Yes. Anaphylaxis can occur without skin symptoms. Difficult or noisy breathing, tongue or throat swelling, persistent coughing, wheezing, a hoarse voice, persistent dizziness or collapse can indicate anaphylaxis even when there are no hives.
How long do you hold an EpiPen in place?
Current ASCIA instructions say to push the EpiPen® down firmly against the outer mid-thigh until a click is heard or felt and hold it there for three seconds before removing it.
Can a second dose of adrenaline be given?
Yes. ASCIA advises that further adrenaline may be given if there is no response after five minutes. ANZCOR similarly recommends a second dose for severe anaphylaxis when symptoms are not relieved by the initial dose.
Should someone with anaphylaxis sit or stand up?
They should not stand or walk. Lay the person flat. If breathing is difficult, they may sit with their legs outstretched. If unconscious, use the recovery position; if pregnant and unconscious, place them on their left side. Young children should be held flat rather than upright.
