Anaphylaxis is a severe, rapidly developing allergic reaction that is life‑threatening and requires immediate first aid. Every year in Australia, thousands of people are treated for anaphylaxis in emergency departments, and incidents continue to rise across schools, childcare, workplaces, healthcare settings and the community.

Knowing how to recognise anaphylaxis and administer an EpiPen without delay can save a life.

This guide follows Australian first aid standards and ASCIA guidelines and is essential reading for anyone completing or renewing first aid training.

What Is Anaphylaxis?

Anaphylaxis is a medical emergency caused by a sudden and extreme immune response after exposure to an allergen. It affects multiple body systems at the same time, including:

• Skin
• Airways and lungs
• Heart and circulation
• Digestive system

Without rapid treatment, anaphylaxis can progress to shock, cardiac arrest and death.

🚨 Anaphylaxis always requires immediate EpiPen administration and triple zero (000).

How Common Is Anaphylaxis in Australia?

• Anaphylaxis admissions have more than doubled in the past 20 years
• 1 in 10 infants now has a food allergy
• 2 in 100 Australian adults live with food allergies
• Food, insect stings and medications cause over 90% of cases

The Australasian Society of Clinical Immunology and Allergy (ASCIA) provides national standards for diagnosis and first aid management throughout Australia and New Zealand.

What Causes Anaphylaxis?

Anaphylaxis occurs when the immune system floods the body with chemicals such as histamine after exposure to an allergen.

Common Anaphylaxis Triggers

• Food
• Insect venom
• Medications
• Latex
• Vaccines (very rare)

Most Common Anaphylaxis Triggers in Australia

Food Allergens

• Peanuts
• Tree nuts (almonds, cashews, walnuts, hazelnuts)
• Cow’s milk
• Eggs
• Sesame (mandatory allergen labelling in Australia)
• Wheat, soy
• Fish and shellfish

Peanut and tree nut allergies rarely resolve and are frequently linked to severe anaphylaxis.

🐝 Insect Stings (High‑Risk in Australia)

• Bees and wasps
• Jack Jumper ants (Tasmania and some mainland regions)
• Tick bites (associated with mammalian meat allergy)

💊 Medications

• Antibiotics (penicillin, amoxicillin)
• Pain relief medications (aspirin, ibuprofen)

  Signs and Symptoms of Anaphylaxis

  Symptoms usually appear within minutes and worsen quickly.

  Anaphylaxis Symptoms Include

  Skin

  • Hives, redness, itching, swelling

  Airways & Breathing

  • Wheezing
  • Shortness of breath
  • Chest tightness
  • Trouble swallowing
  • Hoarse voice

  Heart and Circulation

  • Dizziness or fainting
  • Low blood pressure
  • Fast or weak pulse

  Digestive System

  • Abdominal pain
  • Vomiting
  • Diarrhoea

  ⚠️ Important: 10–20% of people have no skin symptoms — absence of hives does NOT rule out anaphylaxis.

  Allergic Reaction vs Anaphylaxis

  Allergic Reaction	Anaphylaxis
  One body system	Two or more systems
  Mild or moderate	Rapidly life‑threatening
  Antihistamines may help	EpiPen required immediately

  ✅ If in doubt, treat as anaphylaxis and give EpiPen.

  EpiPen: The First‑Line Treatment for Anaphylaxis

  🔑 EpiPen First. EpiPen Fast.

  An EpiPen (adrenaline injector) is the ONLY medication that reverses anaphylaxis.

  Early use:

  • Opens airways
  • Reduces throat swelling
  • Improves blood pressure
  • Prevents collapse

  ⛔ Delaying or not using an EpiPen has been linked to fatal outcomes.

  ASCIA Anaphylaxis First Aid Steps (Australia)

  Step‑by‑Step Emergency Response

  Step 1 – Position

  • Lay person flat
  • If breathing is difficult, allow them to sit
  • Pregnant: left side
  • Unconscious: recovery position

  Step 2 – Give EpiPen

  • Outer mid‑thigh
  • Through clothing if required
  • Do NOT use antihistamines first

  Step 3 – Call 000

  • Say “anaphylaxis”

  Step 4 – Second EpiPen after 5 minutes if no improvement

  Step 5 – Observe in hospital for at least 4 hours

  How to Use an EpiPen

  1. Remove blue safety cap
  2. Place orange end against outer mid‑thigh
  3. Push hard until click
  4. Hold for 3 seconds
  5. Remove and massage injection site
  6. Call 000 and monitor

  ✅ Can be injected through clothing

  Biphasic Anaphylaxis (Second Reaction)

  • Occurs in up to 20% of cases
  • Symptoms return after initial improvement
  • Can occur up to 12 hours later

  ➡️ This is why hospital observation is essential after EpiPen use.

  Why First Aid Training Matters

  Anaphylaxis can happen anywhere:

  • Childcare and schools
  • Healthcare and aged care
  • Construction and workplaces
  • Hospitality and community settings

  First aid training builds confidence, speed and correct response — and saves lives.

  Ready to Learn Anaphylaxis First Aid?

  Our nationally accredited first aid courses include: ✅ ASCIA‑aligned anaphylaxis management ✅ Hands‑on EpiPen and Anapen practice ✅ Workplace, childcare and healthcare compliance

  📍 Book your first aid training today and be prepared to save a life.

  References

  1. Australasian Society of Clinical Immunology and Allergy (ASCIA). Anaphylaxis – Causes, Symptoms and Management. ASCIA is the peak professional body for clinical immunology and allergy in Australia and New Zealand and provides national guidelines for anaphylaxis recognition and management. Available at: https://www.allergy.org.au/patients/about-allergy/anaphylaxis [allergy.org.au]
  2. Allergy & Anaphylaxis Australia. Anaphylaxis: Triggers, Emergency Treatment and Prevention. National consumer organisation supporting people at risk of severe allergic reactions, aligned with ASCIA guidance. Available at: https://allergyfacts.org.au/anaphylaxis/ [allergyfacts.org.au]
  3. Royal Australian College of General Practitioners (RACGP). Anaphylaxis: Identification, Management and Prevention. Peer‑reviewed clinical overview of common anaphylaxis triggers and emergency treatment in Australia. Available at: https://www.racgp.org.au/getattachment/5d21302c-f769-43fd-9dc5-42188897a1a6/Anaphylaxis.aspx [racgp.org.au]
  4. Australian Allergy Centre. Anaphylaxis Overview and Risk Factors. Highlights food and nut allergy as high‑risk causes of anaphylaxis in the Australian population. Available at: https://www.australianallergycentre.com.au/types-of-allergy/anaphylaxis/ [australian...tre.com.au]

  Disclaimer: The information provided on this page is for general education purposes only and does not replace nationally accredited first aid training, anaphylaxis training, or medical advice. Always follow current ASCIA guidelines, your organisation’s policies, and undertake formal training with a registered first aid training provider to ensure correct recognition and management of anaphylaxis.