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+First Aid Pocket GuideAustralian quick-reference

First-aid guides Anaphylaxis: severe allergic reaction

Australian quick reference

Anaphylaxis: severe allergic reaction

The urgent steps to take when someone has a severe allergic reaction.

Serious or worsening symptoms? Call Triple Zero (000).

The short answer

Lay the person flat unless breathing is difficult, give their adrenaline injector without delay if available, then call 000. Do not let them stand or walk.

Act on the severe signs

What should happen first?

If anaphylaxis may be happening, give adrenaline without delay if an injector is available, call Triple Zero (000) and do not let the person stand or walk.

Anaphylaxis first aid decisions
What you findDo next
Possible anaphylaxisLay the person flat, give their adrenaline injector without delay if available, and call 000. Do not wait for a rash or a complete diagnosis.
Breathing is difficultAllow them to sit on the ground with legs outstretched only if needed for breathing. If they vomit or become unconscious, use the recovery position; never let them stand or walk.
No response after 5 minutesGive a second adrenaline injector if available and follow the 000 call-taker. Note the time each dose was given.
Unresponsive and not breathing normallyStart CPR and follow 000 instructions. If they are unresponsive but breathing normally, use the recovery position and keep checking breathing.

Four things to remember

See the next decision

These visual cues are a memory aid. In a real emergency, call Triple Zero (000) and follow the call-taker's instructions.

DO THIS FIRSTStart here

Lay the person flat and do not let them stand or walk. If breathing is difficult, allow them to sit with legs outstretched.

RECOGNISELook for this

Difficult or noisy breathing, wheeze, persistent cough, a hoarse voice or difficulty talking.

DO NOTAvoid this

Do not let the person stand or walk.

CALL 000Escalate when needed

Breathing difficulty, throat or tongue swelling, wheeze, collapse, sudden dizziness or a severe reaction involving multiple body systems requires 000.

Illustrated field notes

These original illustrations support recall. They are not a substitute for the written steps, a current first-aid course or the Triple Zero (000) call-taker.

Illustration of a helper keeping a person with anaphylaxis safe while another person calls Triple Zero and an adrenaline injector is ready.
Treat as an emergencyAdrenaline, then 000

Use the adrenaline injector without delay if available, then call 000.

Educational illustration showing a person with suspected anaphylaxis lying flat with a helper nearby.
Position mattersKeep them lying flat

Do not let the person stand or walk; if breathing is difficult, sit them with legs outstretched.

Generic educational illustration of an adrenaline autoinjector held against the outer thigh at a right angle.
Use the deviceOuter thigh, right angle

Follow the person’s action plan and the device instructions; record the time.

Illustration of a helper monitoring a person after adrenaline while ambulance responders arrive.
Keep monitoringStay until help takes over

Symptoms can return. Follow 000 instructions and give a second dose only when directed and available.

Visual memory cue

See the pattern before you practise

Use this simple visual reminder alongside the written steps. In a real emergency, call Triple Zero (000) and follow the call-taker's instructions.

  1. 01Lay flatDo not let the person stand or walk.
  2. 02Give adrenalineUse the injector without delay if available.
  3. 03Call 000Say “anaphylaxis” and follow instructions.
  4. 04MonitorRepeat after five minutes if needed.

01

What to do first

  • Lay the person flat and do not let them stand or walk. If breathing is difficult, allow them to sit with legs outstretched.
  • Help the person use their adrenaline injector immediately if one is available.
  • Call 000 and say anaphylaxis.
  • If there is no improvement after five minutes, give a second injector if available.
  • Stay with them and begin CPR if they become unresponsive and are not breathing normally.

02

What to avoid

  • Do not let the person stand or walk.
  • Do not rely on antihistamines for anaphylaxis.
  • Do not delay adrenaline while looking for other treatments.

03

When to call 000

  • Breathing difficulty, throat or tongue swelling, wheeze, collapse, sudden dizziness or a severe reaction involving multiple body systems requires 000.

04

What to monitor

  • Watch breathing and response continuously until help arrives.

Recognition cues

What you may notice

  • Difficult or noisy breathing, wheeze, persistent cough, a hoarse voice or difficulty talking.
  • Swelling of the tongue or tightness in the throat, persistent dizziness or collapse.
  • A pale, floppy young child, with or without skin symptoms.
  • Hives or welts, swelling of the face or lips, abdominal pain or vomiting may occur, but anaphylaxis can happen without a rash.

Avoid these traps

Common mistakes

  • Waiting for a rash, a second body system or a complete diagnosis before giving adrenaline.
  • Using an antihistamine or asthma reliever instead of giving adrenaline first for suspected anaphylaxis.
  • Letting the person stand or walk, including to find a bathroom, vehicle or help.
  • Putting the person in the wrong position: lay them flat, allow sitting with legs outstretched only when breathing is difficult, and use the recovery position if they vomit or become unconscious.
  • Failing to call 000, repeat adrenaline after 5 minutes when symptoms persist, or arrange hospital observation.
Children and babies

A young child may look pale and floppy rather than describing breathing or throat symptoms. Hold the child flat and do not let them stand or walk. Use the child dose adrenaline device or the child action plan when prescribed, and follow the device instructions. If the child is unconscious, use the recovery position; if they are unresponsive and not breathing normally, start CPR and follow 000 instructions.

When help is on the way

Keep the handover useful

  • If symptoms persist 5 minutes after the first adrenaline injection, give a second adrenaline device if available and follow the 000 call-taker.
  • Transfer the person to hospital for at least 4 hours of observation because symptoms can return after initial improvement.
  • Tell responders what may have triggered the reaction, when symptoms started, which device and dose were given and whether symptoms changed.

Practise the pattern

Make it easier to remember

Anaphylaxis: the backyard birthday

Common questions

Quick answers

What if symptoms improve?

Still call 000 and keep the person under observation. Symptoms can return.

Can anaphylaxis happen without a rash?

Yes. Severe and sudden breathing difficulty, wheeze, persistent cough or a hoarse voice can be anaphylaxis even when there are no skin symptoms. Give adrenaline first and call 000.

What if the person improves after adrenaline?

Still call 000 and arrange hospital care. Symptoms can return, so keep the person under observation and do not let them stand or walk.

What if the person also has asthma?

For suspected anaphylaxis, give the adrenaline device first, then use the asthma reliever as directed while waiting for emergency help.

Keep it close

Print the reminder

Anaphylaxis action guide
References and update notesAugust 2026

Expanded with a first-screen decision table, recognition cues, common positioning and medication errors, child notes, repeat-dose and observation guidance and additional FAQs against current Healthdirect, ASCIA and ANZCOR guidance.