15

Sudden widespread rash, difficulty breathing, or dizziness — treat as anaphylactic shock; call 120 immediately and explain the situation clearly

UpdatedGrade BBig benefitLifespanFreeLittle timeNo willpower

If someone suddenly develops a full-body rash along with trouble breathing or dizziness, treat it as anaphylactic shock. Call 120 right away and clearly state “suspected anaphylactic shock” so emergency responders can bring epinephrine with them. Epinephrine is the first-line treatment; antihistamines and steroids act too slowly to be effective in such cases. Individuals who have experienced this before should consult a doctor for an epinephrine auto-injector and learn how to administer it to the outer midsection of the thigh — this can be done even through clothing.

Cost
No cost involved. However, people with known severe allergies must purchase epinephrine auto-injectors themselves; these are prescription-only medications.
Benefit
Epinephrine is the recommended first-line treatment for all grades of anaphylactic shock (Grade 2 and above); clinical guidelines strongly endorse its use. Antihistamines and steroids are much slower-acting and cannot replace epinephrine in emergency situations.
Notes
The EAACI allergy guidelines themselves note that “most evidence in this field remains at a low level.” They still classify epinephrine as a strongly recommended treatment because its benefits far outweigh the risks, rather than because of large-scale clinical trials. In China, epinephrine is a prescription medication and is not readily available to the general public. The best immediate action is to call 120 and clearly describe “suspected anaphylactic shock” so emergency teams can bring epinephrine along. Those with a history of severe allergic reactions should consult a doctor for an epinephrine auto-injector and learn how to inject it into the outer midsection of the thigh — this can be done through clothing as well.
Sources · 2
  1. 中国医药教育协会等 (2022). 过敏性休克急救临床实践指南(2020). Frontiers in Pharmacology:「Epinephrine is the first-line medicine in GRADE II to IV anaphylaxis」「Intramuscular epinephrine should be injected in the mid-anterolateral thigh」,成人肌注上限 0.5 mg、14 岁以下 0.3 mg,无反应可每 5–15 分钟重复一次. doi.org/10.3389/fphar.2022.845689
  2. Muraro A, et al. (2022). EAACI guidelines: Anaphylaxis (2021 update). Allergy. doi.org/10.1111/all.15032

← Read the whole chapter: 13. Emergency situations: what to do first

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