Severe Allergic Reactions & Epinephrine
A severe allergic reaction, called anaphylaxis, can close the airway and drop blood pressure within minutes. Outdoor workers face bee, wasp and fire ant stings; anyone can react to foods, latex or medicines. Epinephrine given quickly saves lives.
- All workers
- Outdoor workers
Photo: epinephrine auto-injector being pressed against the outer thigh through work pants
Signs of anaphylaxis
- Trouble breathing, wheezing or a tight throat
- Swelling of the face, lips, tongue or throat
- Hives or widespread itching and redness
- Dizziness, fainting, or a weak, fast pulse
- Vomiting, cramps or diarrhea
- A sense that something is very wrong
Symptoms usually start within minutes but can take up to an hour or more.
What to do
- Call 911.
- Help them use their epinephrine auto-injector right away, in the outer thigh. It can go through clothing. Follow the instructions on the device.
- Positioning: lay them down with legs raised if they feel faint; let them sit up if they’re having trouble breathing; on their side if vomiting.
- A second dose may be given after 5 to 15 minutes if symptoms don’t improve and a second injector is available.
- Start CPR if they stop breathing normally. See CPR & AED.
Everyone who gets epinephrine needs emergency care, even if they feel better. Symptoms can come back hours later.
Stings
- Scrape a honeybee stinger out quickly with a fingernail or card.
- Wash the area and apply cold for local swelling.
- Watch for signs of a severe reaction for the next hour.
- Watch for nests in equipment, under eaves, in the ground and in irrigation boxes.
Plan ahead
- If you have a known severe allergy, carry two auto-injectors, and tell your supervisor and a coworker where they are.
- Employers can include allergy response in first aid training and emergency plans.
- Use nitrile gloves instead of latex if anyone is allergic to latex.
Standards & references
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