Allergic reactions can range from mild irritations to life-threatening emergencies, but in the moment, it can be hard to tell how severe the reaction is. Knowing what to do during an allergic reaction and understanding first aid for allergic reactions gives you the confidence to act while professional medical help is on the way.
Recognizing the Symptoms of Anaphylaxis
Not every allergic reaction is anaphylaxis. A mild reaction might cause itching, hives, a runny nose, or localized swelling. Anaphylaxis, however, is a severe allergic reaction that affects multiple body systems, including respiration and circulation, and it can become life-threatening within minutes.
Common symptoms of anaphylaxis include:
- Difficulty breathing, wheezing, or shortness of breath
- Swelling of the lips, tongue, face, or throat
- Widespread hives or skin reactions
- Dizziness, weakness, or fainting
- Nausea, vomiting, or abdominal pain
- Signs of shock or a change in responsiveness
A person does not necessarily need to display every symptom. If a severe allergic reaction is suspected, don’t wait to see if it gets worse. This is where knowing allergic reaction first aid becomes especially important.
What to Do During an Allergic Reaction
What to do during an allergic reaction depends on the severity of the symptoms. If the person is exhibiting signs of anaphylaxis, treat it as a medical emergency.
First, call 911 or have someone nearby call. While waiting for EMS, begin administering first aid for an allergic reaction.
Help the Person Use Their Epinephrine
Epinephrine is the first-line treatment for anaphylaxis. It works as synthetic adrenaline, relaxing the victim’s airways, increasing blood pressure, and decreasing swelling. If the person has prescribed epinephrine, help them use it according to their emergency action plan and the medication’s instructions.
Keep Them Comfortable and Monitor Them
Watch the victim’s breathing and responsiveness for changes, as well as lingering symptoms of anaphylaxis. If breathing is difficult, help them to sit in a position that makes breathing easier.
Protect them from extreme temperatures. If you’re out in the cold, safely relocate to a warmer area or bring the victim a blanket. If there’s a risk of extreme heat, get indoors or into the shade.
Be Prepared to Perform CPR
If the person becomes unresponsive, begin CPR and use an AED if one is available.
One important point about anaphylaxis first aid: don’t rely on antihistamines to treat anaphylaxis. They may help with some allergy symptoms, but they do not replace epinephrine or address the life-threatening breathing and circulation problems associated with anaphylaxis.
A New Option: FDA-Approved Epinephrine Nasal Spray
There’s an important development in first aid for allergic reactions that people with severe allergies, parents, caregivers, teachers, and workplaces should know about.
In August 2024, the FDA approved neffy as the first FDA-approved nasal spray for emergency treatment of Type I allergic reactions, including anaphylaxis. Unlike traditional epinephrine auto-injectors, neffy delivers epinephrine through the nose rather than by injection. The FDA subsequently expanded its approval in March 2025 to include children ages 4 and older who weigh at least 15 kg (33 pounds). The appropriate dose depends on the person’s weight.
For someone who has been prescribed neffy, knowing how to use it is an important part of allergic reaction first aid. It does not eliminate the need for emergency medical care, and victims should still seek emergency medical assistance after treatment, as additional monitoring may be necessary.
Be Prepared Before an Emergency Happens
The best anaphylaxis first aid begins before an emergency. If someone in your family, workplace, school, or organization has a serious allergy, know where their prescribed medication is located and understand their emergency plan.
Preparation isn’t just about having supplies available. You should also know what to do when someone is struggling to breathe, falls unresponsive, or experiences other symptoms of anaphylaxis.
At Specialized Health and Safety, we provide CPR, First Aid, and BLS training designed to give individuals and organizations practical skills they can use when seconds matter. Our classes are available for individuals and groups, and we can accommodate training needs both on and off site.
Knowing what to do during an allergic reaction turns panic into action. Sign up for a first aid class with Specialized Health and Safety and learn the skills needed to respond with confidence when someone needs help.
