Allergy & Anaphylaxis Response
Version 1.0 · Last reviewed July 2026 · Review cadence: Quarterly (immediate on major guideline changes)
Confirm this live card before relying on any number or rule below. This card changes on a Quarterly (immediate on major guideline changes) cadence.
SIGNS OF ANAPHYLAXIS — A SEVERE, LIFE-THREATENING REACTION
Any of: trouble breathing, wheezing, or throat tightness; swelling of the lips, tongue, or throat; widespread hives; repetitive vomiting; pale or bluish color, dizziness, or collapse; or a sense of “something is very wrong” after exposure to a known or suspected allergen. A reaction involving two body systems, or any breathing or circulation symptom, is anaphylaxis until proven otherwise.
ACT IN THIS ORDER
1. Give epinephrine immediately (the prescribed auto-injector, outer thigh). Epinephrine first — do not wait, do not give an antihistamine instead, do not “wait and see.” Delay is the greatest danger.
2. Call 911. Say the word “anaphylaxis” and that epinephrine was given.
3. Keep the child lying down with legs elevated (sitting up only if breathing is easier that way); do not let her stand or walk.
4. A second dose may be given after 5–15 minutes if symptoms persist and EMS has not arrived. Every child with a reaction needs emergency evaluation even if symptoms improve — a second wave can follow.
The child’s own written emergency care plan controls doses and steps. Six-step workflow: Volume 1, Unit 4.