Epinephrine is the first-line medication which should be used in the emergency management of a person having a potentially life-threatening allergic reaction. In studies of individuals who have died of anaphylaxis, epinephrine was underused, not used at all, or administration was delayed
Antihistamines and asthma medications must not be used as first-line treatment for an anaphylactic reaction. They are acceptable as additional or secondary medication. Antihistamines alone will not halt anaphylaxis.
Additional epinephrine must be available during transport. A second dose may be administered within 10 to 15 minutes, or sooner, after the first dose if symptoms have not improved. The second dose should only be given if the reaction is continuing or getting worse.
Individuals with anaphylaxis who are feeling faint or dizzy should lie down unless they are vomiting or experiencing severe respiratory distress. To improve blood circulation, lift the person’s legs above the level of the heart, and keep the legs raised (e.g. by a pillow). If the person feels nauseated, lay them on their side, head down, to prevent aspiration of vomit.