Anaphylaxis Response Card: What to Do in 5 Steps

Anaphylaxis and Asthma
Anaphylaxis can move fast, and it does not always come with a rash. This one page gives you the five actions in the right order, so you can act with confidence instead of freezing.

By Britt Brennan, REACHAU | Reviewed 13 October 2026. In an emergency, call 000.

REACHAU | FIRST AIDSuspected anaphylaxis: act fastIf in doubt, give adrenaline. No rash does not mean no anaphylaxis.

Position. Lay them flat. Do not let them stand or walk. If breathing is difficult, they can sit with legs outstretched. If unconscious or pregnant, use the recovery position (left side if pregnant). Hold young children flat, not upright.
Give adrenaline. Give it straight away using their prescribed or available device. Follow that device’s own instructions. Do not wait for a rash.
Call 000. Say “anaphylaxis”.
Reassess. If symptoms persist after 5 minutes, give another dose (check the device instructions). Write down the time of each dose and tell the paramedics.
Keep going. If they are unresponsive and not breathing normally, start CPR. Everyone goes to hospital by ambulance, even if they look better.

Signs that need action now

Difficult or noisy breathing
Wheeze or a cough that will not settle
Tongue or throat swelling or tightness
Hoarse voice or trouble talking
Dizziness that does not pass, or collapse
Pale and floppy (young children)
Tummy pain or vomiting after an insect sting

Hives, flushing and facial swelling can happen, but they can also be missing.

Asthma and a known allergy? Sudden breathing difficulty after possible allergen exposure: give adrenaline first, then the asthma reliever. Call 000.
Not a substitute for adrenaline: antihistamines, asthma puffers and steroid medicines.

Device is kept at:Emergency contact:

Educator reference and first aid reminder. It does not replace an individual ASCIA Action Plan, medical advice or hands-on training. Checked against ASCIA on 13 October 2026. Individual red ASCIA Action Plans and the orange ASCIA First Aid Plan take priority. REACHAU | 0481 123 204 | reachau.com.au

The response at a glance

The same five steps as a flowchart. The red boxes are the actions that cannot wait.

Suspected anaphylaxisSudden breathing difficulty, swelling, collapse or dizziness that does not pass, often after an allergen or sting. A rash may be missing.

1. PositionFlat. No standing or walking. Sit with legs outstretched only if breathing is hard. Recovery position if unconscious (left side if pregnant).

2. Give adrenaline nowIf in doubt, give it. Known asthma with sudden breathing difficulty: adrenaline first, then the asthma reliever.

3. Call 000 and say “anaphylaxis”Another helper can call while treatment starts.

4. Five minutes later: do symptoms persist?Write down the time of each dose.

Symptoms persist

Give another doseCheck the device instructions. Keep reassessing and keep the ambulance informed.

Improving

Keep them flat and watchedThe ambulance still comes. Everyone goes to hospital, even if they look better.

At any time: unresponsive and not breathing normally?Start CPR now and use an AED as soon as one is available.

5. Hand over to paramedicsTell them the symptoms, any changes, device details and the time of each dose.

Why the order matters

Adrenaline works on airway swelling, tight airways and falling blood pressure. That is why it comes first. Antihistamines and asthma puffers do not treat the whole reaction, so they cannot take its place.

Position matters too. Standing or walking during anaphylaxis can make a collapse worse, so lying flat (or sitting with legs outstretched if breathing is hard) is part of the treatment, not just comfort.

Know your device

Print it, pin it, share it

Use the print button above to print the card on one A4 page, or save it as a PDF. Put it in the first aid kit, staff room, canteen, club rooms or vehicle. Fill in where the device is kept and who to contact before you pin it up.

Check what you remember

A quick knowledge check, below the emergency steps on purpose. Choose an answer to see why it matters. These questions support learning. They are not a competency assessment or a certificate.

Common questions

Do I need to see a rash before I give adrenaline?

No. Anaphylaxis does not always come with a rash. ASCIA advises that if in doubt, give adrenaline. Act on breathing difficulty, throat or tongue swelling, a hoarse voice or collapse after possible allergen exposure.

How long do I wait before a second dose?

If symptoms persist after 5 minutes, give another dose if one is available, and check that device’s own instructions. Write down the time of each dose and tell the paramedics.

Can an antihistamine or asthma puffer replace adrenaline?

No. Adrenaline treats airway swelling, tight airways and falling blood pressure. Antihistamines, asthma puffers and steroid medicines do not treat the whole reaction, so they cannot take its place.

What if the person has asthma and a known allergy?

If there is sudden breathing difficulty after possible allergen exposure, give adrenaline first, then the asthma reliever, and call 000. Follow any individual ASCIA Action Plan.

Does the person need to go to hospital if they look better?

Yes. Everyone goes to hospital by ambulance, even if they look better. ASCIA advises observation for at least four hours.

Sources and scope

REACHAU (Regional Education and Career Help Australia) | Perth and regional Western Australia | 0481 123 204