What to do for anaphylaxis when no epinephrine injector is available

Do not wait for the reaction to settle or drive around looking for an injector. If another prescribed injector is immediately available and the emergency call handler advises its use, follow their directions while an ambulance is coming.

Anaphylaxis can affect breathing, circulation or both. Warning signs include swelling of the tongue or throat, a hoarse voice, noisy or difficult breathing, wheezing, persistent coughing, faintness, confusion, collapse, or pale and clammy skin. Hives or facial swelling may occur, but a severe reaction can happen without a rash.

Symptoms involving more than one body system after a likely allergen, such as hives together with vomiting or breathing trouble, also raise concern. Treat the pattern as urgent even when the trigger is uncertain.

Remove the trigger only when this is quick and safe, such as stopping a medicine infusion; do not induce vomiting after swallowed food. Help the person lie flat with legs raised. If breathing is very difficult, they may sit with legs extended, and an unconscious breathing person should be placed on their side. A pregnant person should lie on the left side.

Keep the person still, loosen restrictive clothing and monitor breathing and responsiveness. Do not give food, drink or tablets to someone with throat swelling or reduced alertness. If they become unresponsive and are not breathing normally, begin CPR and use an automated external defibrillator if one is available.

Any suspected anaphylaxis needs ambulance assessment and hospital monitoring, including when symptoms begin to improve. Symptoms can return after an apparent recovery, and emergency teams can provide epinephrine, airway support, oxygen, fluids and further treatment as clinically required.

After recovery, ask which trigger is suspected, whether allergy testing is appropriate, how many prescribed injectors to carry, where to store them in UAE temperatures and how household members should use them. Request a written allergy action plan and check injector technique and expiry dates at follow-up visits.