Quick answer: Anaphylaxis is a severe, potentially fatal allergic reaction. If you suspect anaphylaxis, call Triple Zero (000) immediately, lay the person flat (or sit them up if breathing is difficult), administer an adrenaline auto-injector (EpiPen) to the outer mid-thigh if available, and begin CPR if they become unresponsive. Do not leave them alone. A second EpiPen dose may be given after 5 minutes if there is no improvement. Anaphylaxis first aid is covered in all IRFA first aid courses across North Brisbane’s four venues.
What Is Anaphylaxis?
Anaphylaxis is a severe, systemic allergic reaction that occurs rapidly — often within minutes of exposure to a trigger. It affects multiple body systems simultaneously: the skin, respiratory tract, cardiovascular system, and gastrointestinal tract. Without prompt treatment with adrenaline, anaphylaxis can be fatal.
In Australia, the most common triggers include:
- Foods — peanuts, tree nuts, shellfish, fish, milk, eggs, wheat, sesame
- Insect stings — bees, wasps, jack jumper ants (particularly relevant in Queensland)
- Medications — penicillin, aspirin, anti-inflammatory drugs, anaesthetics
- Latex — gloves, medical equipment
- Exercise-induced anaphylaxis — rare but documented, sometimes combined with a food trigger
How to Recognise Anaphylaxis — Signs and Symptoms
Anaphylaxis presents differently in different people. Symptoms usually develop within 5–30 minutes of exposure but can occur up to 2 hours later. Any combination of the following after known or suspected allergen exposure should be treated as anaphylaxis until proven otherwise.
Skin and Mucosal Symptoms (most common but not always present)
- Hives (urticaria) — raised, itchy welts
- Widespread redness and flushing
- Swelling of the lips, tongue, or face (angioedema)
- Itching of the skin, mouth, or throat
Respiratory Symptoms
- Wheezing or noisy breathing
- Throat tightness or hoarse voice
- Persistent cough
- Difficulty breathing or shortness of breath
- Stridor (high-pitched sound when inhaling)
Cardiovascular Symptoms
- Rapid or weak pulse
- Dizziness or fainting
- Pale or grey skin colour
- Loss of consciousness
- Cardiac arrest (in severe untreated cases)
Gastrointestinal Symptoms
- Nausea, vomiting, or diarrhoea
- Cramping abdominal pain
Important: Skin symptoms are absent in approximately 20% of anaphylaxis cases. A person can be in anaphylaxis with only respiratory or cardiovascular symptoms. Do not wait for hives or swelling before acting.
Anaphylaxis First Aid — Step-by-Step Treatment
Follow ASCIA’s (Australasian Society of Clinical Immunology and Allergy) action plan for anaphylaxis first aid:
Step 1 — Lay the person flat
Lay the person flat on their back with their legs raised. If they are having difficulty breathing, allow them to sit up — but do not let them stand or walk. If they are unconscious, place them in the recovery position. Do not let them sit upright suddenly if they have been lying flat, as this can cause cardiovascular collapse.
Step 2 — Call Triple Zero (000)
Call 000 immediately. Tell the operator you suspect anaphylaxis. Do not wait to see if symptoms improve before calling — anaphylaxis can deteriorate rapidly. Ask a bystander to call while you treat the patient if possible.
Step 3 — Administer adrenaline auto-injector (EpiPen)
If the person has a prescribed EpiPen (or EpiPen Jr for children under 20 kg), administer it immediately. Adrenaline is the only effective first-line treatment for anaphylaxis — antihistamines and asthma puffers are not adequate treatment for anaphylaxis, though a reliever puffer may assist respiratory symptoms as a secondary measure.
How to use an EpiPen:
- Remove the blue safety cap from the end of the EpiPen.
- Hold the EpiPen firmly with your dominant hand (orange tip pointing down).
- Place the orange tip against the outer mid-thigh — it can be administered through clothing.
- Push down firmly until you hear a click, then hold in place for 3 seconds.
- Remove and rub the injection site for 10 seconds.
- Note the time of injection. A second dose may be given after 5 minutes if there is no improvement and a second EpiPen is available.
If the person does not have their own EpiPen, some workplaces, schools, and public venues carry general-use adrenaline auto-injectors. From 2023, Australian pharmacists can supply a single EpiPen without a prescription for emergency use in some circumstances.
Step 4 — Monitor and prepare for CPR
Stay with the person and monitor their breathing and consciousness continuously. If they become unresponsive and stop breathing normally, begin CPR immediately. Do not leave them alone at any point.
Step 5 — Await paramedics and administer second dose if needed
Even if the person appears to recover after adrenaline, they must be transported to hospital for observation. Biphasic anaphylaxis — a second wave of symptoms — can occur 1 to 8 hours after the initial reaction, even without further allergen exposure. This is why hospital assessment is essential regardless of apparent recovery.
Anaphylaxis vs Allergic Reaction — When Is It an Emergency?
| Symptom | Mild Allergic Reaction | Anaphylaxis (Emergency) |
|---|---|---|
| Skin | Localised hives, mild itch | Widespread hives, swelling of face/tongue |
| Respiratory | Runny nose, mild sneezing | Wheezing, throat tightness, difficulty breathing |
| Cardiovascular | None | Rapid/weak pulse, dizziness, collapse |
| Consciousness | Alert | Altered or unconscious |
| Treatment | Antihistamine, monitor | Adrenaline (EpiPen) + call 000 immediately |
Anaphylaxis in the Workplace — Queensland Employer Obligations
Under the Work Health and Safety Act 2011 (Qld), employers have a duty to provide a safe workplace, which includes managing the risk of anaphylaxis for workers with known allergies. Practical steps include:
- Identifying workers and visitors with known severe allergies (ASCIA action plans)
- Ensuring first aiders are trained in anaphylaxis recognition and EpiPen administration
- Maintaining a workplace anaphylaxis management plan
- Ensuring EpiPens are accessible, not locked away or expired
- Training designated staff in ASCIA protocols — covered in HLTAID011 Provide First Aid
Schools in Queensland are required under the Education (General Provisions) Act 2006 to have an anaphylaxis management policy and trained staff. The HLTAID012 Childcare First Aid course covers anaphylaxis management in detail for education and care settings.
Learn Anaphylaxis First Aid in North Brisbane
Anaphylaxis recognition and EpiPen administration is a core component of IRFA’s HLTAID011 Provide First Aid course — delivered across four North Brisbane venues by paramedic-qualified trainers:
- Redcliffe Peninsula — Redcliffe RSL, Irene Street
- North Lakes — Community Centre, 10 The Corso
- Virginia / Northgate — Northgate Hall, 34 Ridge Street
- Caboolture — Caboolture Hub, 4 Hasking Street
HLTAID011 Provide First Aid — $95 | 4 hours | Same-day certificate | RTO 32154
View All North Brisbane Sessions and Book →
Or call 1300 766 298 — Mon–Fri 7 AM–6 PM AEST
