When to worry about facial swelling with anaphylaxis

Facial Swelling is a very common presentation of Anaphylaxis. Swelling may involve the eyelids, lips, mouth or tongue and can progress quickly. Anaphylaxis can also cause hives, wheezing, a tight throat, dizziness, vomiting or sudden weakness. The pattern matters more than the amount of visible swelling: swelling near the airway is particularly concerning.

Use the person’s prescribed adrenaline auto-injector immediately if anaphylaxis is suspected, following its instructions, and call emergency services. Keep them lying down with legs raised if comfortable; let them sit if breathing is difficult. Do not give food or drink, and do not leave them alone. A second injector may be needed if symptoms continue and another is available according to the device instructions.

Treat facial swelling as an emergency when it is accompanied by trouble breathing, noisy breathing, voice change, difficulty swallowing, tongue swelling, faintness, confusion, blue or pale lips, or rapidly worsening symptoms. Emergency assessment is needed even if the person improves after adrenaline, because symptoms can return and observation may be required.

Ask which symptoms should trigger your auto-injector, whether you should carry two devices, and how to check their expiry dates. Discuss known triggers, an emergency action plan, and referral for allergy assessment.