Allergic reactions

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Allergic reactions	Allergic reactions	Dermatographism - arm	Dermatographism - close-up
Dermatographism on the arm	Dermatographism on the back	Hives (urticaria) - close-up	Hives (urticaria) on the arm
Hives (urticaria) on the chest	Hives (urticaria) on the trunk

For a mild to moderate reaction:

1. Calm and reassure the person having the reaction, as anxiety can worsen symptoms.
2. Try to identify the allergen and have the person avoid further contact with it. If the allergic reaction is from a honey bee sting, scrape the stinger off the skin with something firm (such as a fingernail or plastic credit card). Do not use tweezers; squeezing the stinger will release more venom.
3. If the person develops an itchy rash, apply calamine lotion and cool compresses. Avoid medicated lotions.
4. Watch the person for signs of increasing distress.
5. Get medical help. For a mild reaction, a physician may recommend over-the-counter medications (such as antihistamines).

For a severe allergic reaction (anaphylaxis):

1. Check the person's airway, breathing and circulation (the ABC's of Basic Life Support). A warning sign for dangerous throat swelling is a very hoarse or whispered voice, or coarse sounds when the person is breathing air in. If the victim is having difficulty breathing, is very weak, or is losing consciousness, call for emergency medical assistance. If necessary, begin rescue breathing and CPR.
2. Calm and reassure the person.
3. If the allergic reaction is from bee stings, scrape the stinger off the skin with something firm (such as a fingernail or plastic credit card). Do not use tweezers -- squeezing the stinger will release more venom.
4. If the person has emergency allergy medication on hand, help the person take or inject the medication. Avoid oral medication if the person is having difficulty breathing.
5. Take steps to prevent shock. Have the person lie flat, elevate the person's feet about 12 inches, and cover him or her with a coat or blanket. DO NOT place the person in this position if a head, neck, back, or leg injury is suspected or if it causes discomfort.
6. If the person loses consciousness, apply first aid for unconsciousness and call 911 or your local emergency number.

• DO NOT Assume that any allergy shots the person has already received will provide complete protection.
• DO NOT Place a pillow under the person’s head if he or she is having trouble breathing. This can block the airway.
• DO NOT Give the person anything by mouth if the person is having trouble breathing.

• The person's allergic reaction is severe or rapidly worsening (over minutes -- see above).
• The person has a history of severe allergic reactions (check for a medical ID tag).

Review Date: 05/03/2006
Reviewed By: David A. Kaufman, M.D., Assistant Professor, Division of Pulmonary, Critical Care & Sleep Medicine, Mount Sinai School of Medicine, New York, NY. Review provided by VeriMed Healthcare Network.