An ambulance should be called as soon as the symptoms occur (dial 15 in France). If the patient is already known to be allergic, a dose of adrenaline should be injected. It is available in auto-injector pen format that is easy to use.
The pen should be held in the writing hand. The protective cap should then be removed from the needle and the injection button. The injection should be administered in the thigh muscle, directly or through clothing. The pen should be held in place for ten seconds. The injection site should then be rubbed. In some cases, if symptoms do not improve, a second injection is necessary. It can be administered between 5 and 10 minutes after the first.
Adrenaline is the cornerstone of treatment for anaphylactic shock! Patients presenting with a severe allergic reaction should always carry two adrenaline auto-injector pens with them, in an isothermal bag if possible, like those used for insulin pens.
Treatment for anaphylaxis does not only involve treatment of the acute episode. It is essential to call an ambulance, by dialing 15 or 112, after the adrenaline injection by intramuscular route, for admission to an emergency unit and so any risk of biphasic reaction can be anticipated (symptom relapse). Referral to an allergologist is primordial. Ideally, appointments are made before discharge from the A&E via specific channels. The assessment makes it possible to identify the underlying immunological mechanism, the triggering factor, and to assess the risk of cross-sensitivity, individual risk factors and factors of recurrence. Personalized supervision is put in place. Prevention and therapeutic education measures are recalled. It may also disconfirm the diagnosis of an allergy meaning certain drugs or foods can be reintroduced.
An individual having sustained an anaphylactic shock should be referred to an allergology unit and should be shown how to use the auto-injector pen, that they should keep with them at all times (two pens). They should also have a card listing their allergies.