Anaphylaxis (emergency; adjunct prevention and recovery only)
Also known as: anaphylaxis, anaphylactic reaction, severe systemic allergic reaction, allergic shock, anaphylactic shock, food-induced anaphylaxis, medicine-induced anaphylaxis, insect-sting anaphylaxis, exercise-induced anaphylaxis, idiopathic anaphylaxis
Anaphylaxis is a severe, rapidly developing and potentially fatal systemic hypersensitivity reaction. It can affect the airway, breathing, circulation, skin, gastrointestinal tract and nervous system. Common triggers include foods, medicines, insect stings, latex and, less commonly, exercise or an unidentified trigger. Anaphylaxis may occur without a rash or other skin symptoms. Warning signs include difficult or noisy breathing, wheeze, persistent cough, throat tightness, tongue swelling, hoarse voice, difficulty speaking, dizziness, collapse, pallor or floppiness in a young child. Abdominal pain or vomiting can indicate anaphylaxis after an insect sting or injected medicine and may accompany other reactions. Intramuscular adrenaline, also called epinephrine, is the first-line emergency treatment and should be administered immediately when anaphylaxis is suspected. In Australia, an available adrenaline autoinjector should be used according to its instructions, followed by a call to triple zero (000) for an ambulance. The person should usually be laid flat and must not be allowed to stand or walk; a person with breathing difficulty may sit with legs extended, and a pregnant person should lie on the left side. Additional adrenaline may be required according to the current ASCIA action plan and emergency guidance. Antihistamines do not treat airway obstruction, bronchospasm or shock and must not replace adrenaline. Corticosteroids are not first-line emergency treatment. Every suspected episode requires medical observation and follow-up, including trigger investigation, allergy-specialist referral where appropriate, an individualised action plan, adrenaline-device education and strategies to reduce future exposure. Acupuncture and Chinese herbal medicine have no role in treating acute anaphylaxis. After complete medical stabilisation, complementary care may be considered only for associated anxiety, general wellbeing or separately diagnosed chronic allergic symptoms. It must never be represented as preventing, reversing or replacing emergency adrenaline treatment. [1][2][3][4][5][6][7][8][9]
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Lifestyle & Diet
- •Carry prescribed adrenaline autoinjectors at all times.
- •Store adrenaline devices according to manufacturer instructions and avoid leaving them in excessive heat or cold.
- •Check device expiry dates regularly and replace expired, damaged or discoloured devices.
- •Keep the current ASCIA Action Plan for Anaphylaxis with the adrenaline device.
- •Ensure family, friends, carers, schools and workplaces know where the device is and how to use it.
- •Practise with a manufacturer-specific trainer device.
- •Use adrenaline immediately when anaphylaxis is suspected; do not wait for a rash.
- •Call triple zero (000) after administering adrenaline in Australia.
- •Do not stand or walk after anaphylaxis begins, even if symptoms appear to improve.
- •Attend allergy-specialist assessment to identify the trigger and discuss risk reduction.
- •Read food labels every time because ingredients and manufacturing processes may change.
- •Ask about ingredients and cross-contact procedures when eating away from home.
- •Avoid foods, medicines or products confirmed as triggers while avoiding unnecessary broad restrictions.
- •Wear medical identification when recommended.
- •Tell doctors, dentists, pharmacists, acupuncturists and other health practitioners about serious allergies.
- •Ensure medicine allergies and the nature of the previous reaction are accurately documented.
- •Do not describe predictable side effects, intolerances and anaphylaxis as interchangeable because management differs.
- •Discuss insect-sting avoidance and venom immunotherapy with an allergy specialist when relevant.
- •Discuss medicine-allergy testing or supervised challenge only with an appropriately trained specialist.
- •Do not deliberately test a suspected trigger at home.
- •Exercise-induced reactions require specialist assessment of food, medicine, temperature and exercise cofactors.
- •Avoid relying on antihistamines as the only emergency medicine.
- •Replace adrenaline devices promptly after use.
- •Seek medical review after every adrenaline-treated reaction.
- •Ask the allergy specialist whether more than one device should be carried based on individual circumstances.
- •Inform airlines, accommodation providers and travel companions of emergency needs when travelling.
- •Carry devices in hand luggage and review destination-specific emergency access before travel.
- •Seek dietetic support for multiple food allergies, especially in children, pregnancy or restrictive diets.
- •Address anxiety without reducing appropriate vigilance or emergency preparedness.
- •Use reputable allergy organisations rather than unverified desensitisation or cure claims.
- •Do not use acupuncture, herbs, supplements, homeopathy, essential oils or energy therapies as substitutes for allergen avoidance and adrenaline preparedness.
Cautions & Contraindications
- •Do not perform acupuncture during active or suspected anaphylaxis.
- •Do not administer oral Chinese herbs, pills, powders, teas or liquids during anaphylaxis.
- •Do not use antihistamines instead of adrenaline for anaphylaxis.
- •Do not use corticosteroids instead of adrenaline as first-line emergency treatment.
- •Do not delay adrenaline because symptoms initially appear mild.
- •Do not wait for skin symptoms before treating airway, breathing or circulatory signs.
- •Do not allow the patient to stand, walk or shower during anaphylaxis.
- •Do not send the patient home after suspected anaphylaxis without emergency medical assessment.
- •Do not claim that acupuncture strengthens immunity in a way that prevents anaphylaxis.
- •Do not claim that Chinese herbs desensitise a patient to a life-threatening allergen without validated specialist immunotherapy evidence.
- •Do not advise deliberate allergen exposure outside a specialist-supervised protocol.
- •Do not advise discontinuation or non-carriage of an adrenaline autoinjector.
- •Do not replace an ASCIA Action Plan with a TCM treatment plan.
- •Do not introduce herbal products without checking all active ingredients, excipients, flavourings, colourings, binders and potential cross-contaminants.
- •Avoid products containing a known or suspected allergen, even when the allergenic ingredient is described as natural or traditionally processed.
- •Animal products, shellfish-derived materials, insect products, fungi, seeds, nuts, latex, bee products and gelatin may provoke allergic reactions in susceptible people.
- •Royal jelly, propolis, bee pollen and other bee products can cause serious allergic reactions and should not be used casually in allergy-prone patients.
- •Bān Máo and other toxic animal-derived substances are contraindicated.
- •Avoid unregulated injectable herbal products because severe allergic reactions and contamination may occur.
- •Avoid topical products on broken skin without allergy and irritation assessment.
- •Do not assume that a previously tolerated herb will always remain safe.
- •Do not use muscle testing, electrodermal testing, pulse diagnosis or unvalidated allergy tests to identify anaphylaxis triggers.
- •Do not recommend broad elimination diets without confirmed clinical need and nutritional supervision.
- •Do not interpret recurrent throat tightness, wheeze, dizziness or collapse as Qi stagnation, panic or a healing response until anaphylaxis and other emergencies have been excluded.
Frequently Asked Questions
What is anaphylaxis?+
Anaphylaxis is a severe, rapidly developing and potentially fatal systemic allergic reaction affecting the airway, breathing, circulation or multiple body systems [1].
What is the first-line treatment for anaphylaxis?+
Intramuscular adrenaline, also called epinephrine, is the first-line treatment and should be administered immediately when anaphylaxis is suspected [1].
What should be done in Australia after using an adrenaline autoinjector?+
Call triple zero (000) and ask for an ambulance, follow the current ASCIA Action Plan and keep the person safely positioned [1].
Can anaphylaxis occur without a rash?+
Yes. A person may have dangerous airway, breathing or circulatory symptoms without hives, itching or facial swelling [1].
Should a person with anaphylaxis stand or walk?+
No. They should generally be laid flat and must not stand or walk. A person struggling to breathe may sit with legs extended, while a pregnant person should generally lie on the left side [1].
When may a second adrenaline dose be needed?+
If symptoms do not improve after 5 minutes, another dose may be required according to the current ASCIA action plan and emergency instructions [1].
Do antihistamines treat anaphylaxis?+
Antihistamines may reduce some skin symptoms but do not treat airway obstruction, bronchospasm or shock and must never replace adrenaline [1].
Can acupuncture treat anaphylaxis?+
No. Acupuncture has no role in reversing anaphylaxis and must not delay adrenaline, ambulance activation or resuscitation [10].
Can Chinese herbs prevent future anaphylaxis?+
No Chinese herbal formula has been established as a reliable prevention for anaphylaxis. Herbs can themselves trigger serious allergic reactions [10].
Why is medical observation needed after symptoms improve?+
Symptoms can persist or recur after initial improvement, and the patient requires monitoring, trigger assessment and a future emergency plan [1].
What follow-up is recommended after anaphylaxis?+
Follow-up may include allergy-specialist assessment, an individual action plan, adrenaline-device prescription and training, trigger avoidance advice and psychological support when needed [1].
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Sources & Further Reading
Clinical guidance, red flags and safety notes on this page draw on the following current sources alongside the classical references above.
- Australasian Society of Clinical Immunology and Allergy · 2026
Current Australian and New Zealand professional guidance stating that suspected anaphylaxis requires immediate adrenaline and detailing acute management.
- Australasian Society of Clinical Immunology and Allergy · 2026
First-aid signs, adrenaline-first instructions, safe positioning and ambulance activation.
- Australasian Society of Clinical Immunology and Allergy · 2026
Current advice that another adrenaline dose may be required after 5 minutes and that it is safer to administer adrenaline when in doubt.
- Australasian Society of Clinical Immunology and Allergy · 2026
Current instructions concerning available adrenaline devices and repeated emergency dosing.
- Australasian Society of Clinical Immunology and Allergy · 2026
Professional guidance on adrenaline, positioning and emergency management during pregnancy.
- Healthdirect Australia · 2026
Australian public-health guidance identifying anaphylaxis as life-threatening and instructing immediate autoinjector use and a triple-zero call.
- Healthdirect Australia · 2026
Australian information on adrenaline-device purpose and emergency administration.
- Healthdirect Australia · 2026
Explains that adrenaline reverses severe allergic-reaction symptoms and should be used immediately during suspected anaphylaxis.
- Healthdirect Australia · 2026
Australian guidance on adrenaline-device carriage and individual allergy action plans.
- World Health Organization · 2020
International reference for acupuncture practice, competency and patient safety.
Educational reference for licensed practitioners. Not a substitute for individual clinical assessment. Refer to conventional care for any red-flag or undiagnosed presentation.