Recognising and responding to anaphylaxis

Anaphylaxis is a severe allergic reaction. It can get worse very quickly and it can kill. It is always a medical emergency.

Know the signs. They include swelling of the throat or tongue, and very fast or difficult breathing or wheezing. The person may have trouble swallowing, a tight throat or a hoarse voice. They may feel faint, dizzy or confused, or they may collapse. Their skin may feel cold, and their skin, lips or tongue may look blue, grey or pale. A swollen, raised or itchy rash may also appear.

Act at once. Do not wait to see if it gets better. Two things need to happen straight away, so if a colleague is with you, do them at the same time.

Use the person's adrenaline auto-injector if they have one. Instructions are on the side of the device. Help them if they cannot do it themselves. Call 999 for an ambulance and say 'anaphylaxis'. Give your address clearly. If you are alone, use the auto-injector first and call 999 straight after.

Lay the person flat with their legs raised. If they are struggling to breathe, raise their shoulders or help them to sit up slowly. If they are pregnant, lie them on their left side. Do not let them stand or walk, even if they feel better.

If there is no improvement after 5 minutes, use a second auto-injector if they have one. Stay with them and do not leave them alone. If they stop breathing, follow the instructions from the 999 call handler.

Do not give them water and wait. Do not walk them outside for fresh air. Do not send them home. When the ambulance arrives, tell the crew what the person ate and when adrenaline was given.

Afterwards, tell your manager. Keep the food, the packaging and the order slip. Write down what happened and when. Then check your allergen records and procedures, so that the same mistake cannot happen again.