Allergic Reaction First Aid: What to Do

What are the symptoms of an allergic reaction?

Your body’s reaction to an allergen depends on what you’re allergic to. Many parts of your body might react, such as your:

• airways
• nose
• skin
• mouth
• digestive system

Common symptoms

The following table shows which symptoms commonly occur with each type of allergy:

Anaphylaxis or severe reactions

The most serious allergic reactions can cause anaphylaxis within minutes of allergen exposure. Without treatment, anaphylaxis can lead to loss of consciousness, respiratory distress, and cardiac arrest.

Symptoms of anaphylaxis include:

• skin reactions, such as hives, itching, or pale skin
• wheezing or trouble breathing
• lightheadedness, dizziness, or fainting
• facial swelling
• nausea
• a weak, fast pulse
• vomiting
• diarrhea

Get emergency help if you or someone you’re with is experiencing anaphylaxis, even if the symptoms start to subside. Symptoms can sometimes return in a second phase of the reaction.

What to do when someone is experiencing anaphylaxis

If you’re with someone who is experiencing anaphylaxis, you should:

1. Call 911 immediately.
2. Find out whether the person has an epinephrine auto-injector (often known by the brand name “EpiPen”) and help them inject the medication if they cannot do it.
3. Try to keep them calm.
4. Help them lie on their back.
5. Raise their feet about 12 inches and cover them with a blanket.
6. Turn them onto their side if they’re vomiting or bleeding.
7. Make sure their clothing is loose so they can breathe.

The sooner the person gets their epinephrine, the better.

Do not give them oral medications or anything to drink.

If you have allergies that may lead to an anaphylactic reaction, your doctor can prescribe emergency epinephrine. Each auto-injector contains a single dose of medication that you can inject into your thigh.

It’s important that you carry an auto-injector with you at all times if you have a history of severe allergies or if your doctor has advised you to do so. You should also teach your family and close friends how to inject the epinephrine in case of an emergency.

CPR for anaphylaxis

If someone has had an anaphylactic reaction and is not breathing, coughing, or moving, you may need to perform CPR. You can do this even if you don’t have formal CPR training. CPR involves doing chest presses, about 100 per minute, until help arrives.

If you’re interested in learning CPR, you can contact the American Heart Association, the American Red Cross, or a local first aid organization for training.

Treatments for allergic reactions

Over-the-counter (OTC) antihistamines and decongestants might relieve minor symptoms of an allergic reaction. But you should talk with your doctor before taking any OTC medication to treat allergy symptoms.

Antihistamines prevent symptoms such as hives by blocking histamine receptors so your body doesn’t react to allergens. Decongestants help clear your nose and are especially effective for seasonal allergies — but do not take them for more than 3 days, as doing so may cause allergic reaction symptoms to return or worsen.

These medications are available as tablets, eye drops, and nasal sprays. Many OTC drugs cause drowsiness, so do not take them before driving or doing work that requires a lot of concentration.

To help reduce swelling, itching, and skin redness or other discoloration, you can apply ice and topical creams that contain corticosteroids.

If OTC medications don’t work to reduce your mild allergy symptoms, make an appointment with your doctor. And call your doctor right away if you have an allergic reaction to a medication.

Treatments for food allergies

The best remedy for a food allergy is usually to prevent a reaction by avoiding foods that trigger your allergy. If you accidentally eat a food you’re allergic to or otherwise come into contact with it, OTC drugs can help reduce the reaction. But these drugs can only help relieve hives or itching.

Oral cromolyn can help treat your other symptoms. It’s available only by prescription, so talk with your doctor.

If you have severe food allergies, carry epinephrine with you to treat any reaction you might have.

Treatments for plant or bite allergies

The treatment for a plant or bite allergy varies depending on the type of allergen.

Poisonous plants

According to the Journal of the American Medical Association, up to 75% of adults in the United States will have an allergic reaction when they touch poison ivy, poison oak, or poison sumac. A sticky substance on these plants, which is called urushiol, binds to your skin upon contact.

Symptoms can range from mild redness and itching to severe blisters and swelling. The first time you have contact with one of these plants, a rash might take up to 3 weeks to appear. But if it’s not your first exposure, the rash may develop sooner, within 1 to 2 days. In either case, the rash usually lasts 1 to 3 weeks.

If you’ve touched poisonous plants, take the following steps:

1. Avoid touching other areas of your body, especially your face.
2. Clean the affected area with soap and water for at least 10 minutes.
3. Take a cool bath.
4. Apply calamine lotion or another anti-itching lotion three or four times per day to relieve itching.
5. Soothe inflamed areas with oatmeal products or 1% hydrocortisone cream.
6. Wash all clothing and shoes in hot water.

These steps focus on removing the urushiol from your skin. Severe reactions in children may require a doctor’s visit, and a doctor may prescribe oral steroids or stronger creams to ease symptoms.

Contact your doctor if you have a high fever and any of the following symptoms:

• worsening itching
• a rash that spreads to sensitive areas, such as your eyes or mouth
• a rash that does not improve
• a rash that is tender or has pus and yellow scabs

Despite some claims, there’s no scientific evidence to suggest that scratching an open wound leads to poison in your bloodstream. The leftover oil (urushiol) touches only the immediate area. You can avoid spreading the oil by immediately washing the affected area with soap and water.

Insect stings

Most people will have some reaction to an insect bite, but the most serious reaction is an allergic one. According to the American College of Allergy, Asthma, and Immunology, 1.6% to 5.1% of people in the United States may have had a life threatening allergic reaction to an insect sting at some point.

Most common insect stings are from:

• bees
• wasps
• yellow jackets
• hornets
• fire ants

You can treat insect stings with these first aid methods:

1. Remove the stinger with a straight-edged object, such as a credit card, using a brushing motion. Avoid pulling or squeezing the stinger or using tweezers to remove it, as doing so may release more venom into your body.
2. Wash the area with soap and water, and then apply an antiseptic.
3. Apply hydrocortisone cream or calamine lotion. Cover the area with a bandage.
4. If there’s swelling, apply a cold compress to the area.
5. Take an antihistamine to reduce itching, swelling, and hives.
6. Take an OTC pain reliever if needed.

If you’re pregnant, get the OK from your doctor before taking any OTC medications.

Children should not take aspirin because of the risk of a rare but fatal condition called Reye syndrome.

Jellyfish stings

The American Red Cross recommends taking the following steps if a jellyfish stings you or someone else:

1. Remove any tentacles from the skin. You can rinse them off with seawater or use an object to scrape them off. You can also use your hand, but be sure to cover it with a glove, towel, or plastic bag first.
2. Submerge the affected area of skin in hot water for 20 minutes, or apply another heat source such as a chemical heat pack.
3. Apply lidocaine gel if you have it. (If you don’t have a heat source to use in step 2, you can apply this gel right after step 1.) Do not rub the skin or cover it with an elastic bandage.
4. Monitor the person’s condition for changes or symptoms of shock.

While you might have heard that urinating on a jellyfish sting can reduce the pain, older research has not found it to be helpful. In fact, it might increase the pain.

Treatment for drug allergies

If you experience a serious drug reaction, antihistamines, corticosteroids, or epinephrine may be necessary to treat it.

For most types of drug allergies, your doctor should be able to prescribe an alternative medication to help you avoid a reaction.

Otherwise, your doctor might recommend a desensitization procedure, which involves taking small doses of the medication until your body can manage the dosage you need.

How to prevent allergic reactions

Once you’ve had an allergic reaction, it’s important to identify the trigger and avoid future contact with that allergen.

If you have ingredient-specific allergies, check the ingredients on foods or other products before purchase. Applying lotion before going hiking or camping may help prevent poison ivy from spreading or absorbing into your skin.

The more you can avoid contact with allergens, the less likely you are to have an allergic reaction. Make sure your family, friends, and co-workers know about your allergies. Tell them where you keep your epinephrine auto-injector and show them how to use it. Teaching others how to treat an allergic reaction can help save a life.

Takeaway

Allergies to substances such as foods, insect stings, and medications can range from mild to serious. While some allergic reactions may cause only mild irritation, a severe reaction can lead to a life threatening condition called anaphylaxis.

Symptoms of anaphylaxis include itching, hives, nausea, and trouble breathing. If you or someone you’re with develops symptoms of anaphylaxis, call 911.

If you have severe allergies, your doctor will prescribe an epinephrine auto-injector. Carry it with you at all times in case of a reaction, and use it at the first sign of symptoms.

For mild allergic reactions, first aid procedures and OTC medications can help reduce pain and irritation.

The best way to prevent a reaction is to avoid any substances you’re allergic to.