If you have always experienced milder attacks with minimal or no breathing difficulties we usually recommend that you immediately take antihistamine medication and monitor the situation for a few minutes before giving adrenaline. Milder symptoms then usually resolve over the next half hour. Always make sure you have someone with you who knows about your condition and who can seek further help if necessary.
Make sure that you do not over exert yourself, have a hot bath or get hot, rather remain cool, as increasing the circulation can lead to more severe and rapid allergic reactions. Concomitant asthma is an additional risk factor for food anaphylaxis.
All people who have had anaphylaxis should go to the local hospital Emergency Unit for further observation. This is because when the adrenaline wears off they may need further treatment, such as antihistamines, corticosteroids and occasionally oxygen and intravenous fluid therapy. We would also recommend that you go to your local hospital and introduce yourself to the medical team so that they are aware of your anaphylactic tendency. There is a risk of developing a delayed or biphasic reaction 8 to 12 hours after the initial reaction and you should remain in the Emergency Unit for at least 4 hours for observation.
Patients with Idiopathic Anaphylaxis may need to stay on low-dose oral cortisone for prolonged periods of time to prevent further attacks.
When referred to an allergy clinic, the specialist will take an extensive “allergy history” to try and clearly identify the cause of the anaphylaxis. They will then perform allergy tests on a blood sample using the updated RAST test called a CapRAST. This test measures specific IgE antibodies in the patient’s blood to the suspected allergens. Skin testing is not recommended for diagnosing anaphylaxis as these tests run the risk of triggering an allergic reaction. Blood RAST tests are completely safe and the recommended method of testing for the cause of anaphylaxis. In some situations, patients may have what looks appears to be an anaphylactic reaction - which is in fact a fainting spell or sudden drop in blood pressure. In this situation, we recommend a blood test which measures Mast Cell Tryptase a protein released in the body during anaphylaxis. This is measured in the blood up to 12 hours after the reaction and can confirm that anaphylaxis has indeed occurred. We can also measure Methyl Histamine in the urine as a marker of anaphylaxis having taken place.
First aid measures
Emergency care for someone with suspected anaphylaxis- If the person is conscious and having breathing difficulties, help them to sit up. If they are shocked with low blood pressure, they are better off lying flat with their legs raised.
- If the person is unconscious, check their airways and breathing and lie them in the recovery position. Administer their asthma inhaler if available.
- If you know that the person is susceptible to anaphylaxis, check if they carry a preloaded adrenaline syringe (EpiPen or Anapen). If necessary, help the person to inject it into the muscle of the thigh. This can be administered through clothing.
- Dial 999 for an ambulance and tell the controller that you think the person may have anaphylaxis. If available, antihistamine and steroid tablets should also be given.
How can we prevent anaphylaxis?
If you have ever had an anaphylactic reaction, you must be referred to an Allergy Clinic for full assessment so as to identify the cause of the reaction.(published with permission in writing from:http://www.allergy-clinic.co.uk)


