Recognising and Responding to Anaphylaxis at Work

Recognising the signs of anaphylaxis

Anaphylaxis is a severe, life-threatening allergic reaction that can develop within minutes. In a small business, you might be the first person on the scene, so knowing what to look for is vital. The classic signs are swelling, breathing difficulty and a sudden rash. But anaphylaxis can present in different ways.

Look for:

• Swelling of the face, lips, tongue, throat or around the eyes.
• Breathing difficulty – wheezing, gasping, a hoarse voice, or a feeling that the throat is closing.
• A sudden rash – raised, itchy hives (nettle rash) or flushed, blotchy skin.
• Other warning signs: a sudden drop in blood pressure causing dizziness, faintness or collapse; abdominal pain, nausea or vomiting; a sense of impending doom.

Symptoms can start mildly and escalate quickly. A person may not have all these signs. If you see any one of them after a known or suspected allergen exposure – such as food, an insect sting, or latex – treat it as an emergency. Do not wait to see if they improve.

The first response: auto-injector first, then call 999

If someone shows signs of anaphylaxis, act immediately. The priority is to give adrenaline using an auto-injector, then call 999. Adrenaline is the only effective treatment for anaphylaxis and works within minutes to reverse the reaction.

Help the person into a comfortable position. Usually, they should lie flat with their legs raised to improve blood flow. If breathing is difficult, they may prefer to sit up – but do not let them stand or walk around, as this can worsen the reaction. If they are unconscious, place them in the recovery position.

If the person has their own auto-injector, use it. If you have a spare workplace injector and the person cannot use theirs, use that. Do not hesitate. There is no harm in giving adrenaline to someone who is not actually having anaphylaxis, but delay can be fatal.

Using an adrenaline auto-injector correctly

Auto-injectors are designed to be simple, but you need to know the basics. The device is usually a pen-like injector with a blue or orange cap and a needle hidden inside. Here’s what to do:

• Check the device – make sure it’s in date and the solution is clear, not discoloured.
• Remove the safety cap – follow the instructions on the device.
• Inject into the outer thigh – this can be done through clothing if necessary. The thigh is the safest site because it’s a large muscle.
• Hold for the recommended time – usually 3 to 10 seconds, depending on the device. Then remove.
• Note the time – you may need a second dose after 5 minutes if symptoms don’t improve and another injector is available.

After injecting, call 999 if you haven’t already. Keep the person still and monitor their breathing. If they become unresponsive, be prepared to start CPR.

What to tell the emergency services

When you call 999, the operator will need clear information. Say calmly:

• “Anaphylaxis” – this immediately tells them it’s a life-threatening allergic reaction.
• Your exact location – including the business name, street, and any access details like a door code.
• What happened – the suspected trigger, the symptoms you saw, and when you gave the auto-injector.
• The person’s condition – are they breathing? Conscious? Have they improved?

Stay on the line and follow any instructions. Even if the person seems to recover, they must go to hospital. A second reaction (a biphasic reaction) can occur hours later without further exposure. Do not let them drive themselves or leave alone.

Planning ahead for small businesses

Anaphylaxis is rare, but as a small business you have a legal duty to manage health and safety risks, including first aid. Preparation makes all the difference. Here’s how to get ready:

• Ask about allergies – during onboarding, discreetly ask if anyone has a known allergy that could lead to anaphylaxis, and what they need.
• Create an individual plan – for anyone at risk, agree where their auto-injector is kept, who knows about it, and what to do in an emergency.
• Train your first aiders – ensure they know how to recognise anaphylaxis and use an auto-injector. Regular refreshers build confidence.
• Keep injectors accessible – not locked in a cupboard or left in a bag. A spare workplace injector can save a life if someone’s own is not to hand.
• Consider your triggers – if you have a staff kitchen, offer clear labelling of food. If you work with latex, provide alternatives.
• Practise – run a simple scenario at a team meeting. Knowing where the injector is and how to use it reduces panic.

You don’t need a complicated system. A short written plan, a few trained people, and an accessible auto-injector can make your workplace safer. Most importantly, talk about it openly. Anaphylaxis is frightening, but with the right response, you can save a life.