Home · What to do · Angioedema and anaphylaxis: the first minutes

Angioedema and anaphylaxis: the first minutes

Swelling of the lips and eyelids is unpleasant; swelling of the tongue and throat is lethal within minutes. Anaphylaxis is the whole-body version: a drop in blood pressure, wheezing, vomiting, collapse. The only drug that reverses it is adrenaline, and it works best given early, into the thigh.

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What to do right now

Remove the trigger
Stop the medication or food, remove the sting; if it is an insect bite on a limb, apply cold above the site.
Adrenaline if you have an auto-injector
Into the outer thigh, through clothing if needed. A second dose after 5–15 minutes if there is no improvement. Adrenaline is never "just in case" — in anaphylaxis it is the treatment.
Antihistamine
Cetirizine, loratadine or similar; for swelling — with a corticosteroid if prescribed by your doctor. Antihistamines alone do not treat anaphylaxis.
Position matters
If blood pressure is low — lie flat with legs raised. If breathing is difficult — sit up. Never let them stand or walk.
Call and stay
Anaphylaxis can return 4–12 hours after the first episode, which is why observation in hospital is standard.

Call an ambulance if

Swelling of the tongue, lips, throat; hoarse voice, barking cough, difficulty swallowing
Wheezing, shortness of breath, feeling of a lump in the throat
Widespread hives with dizziness, weakness, vomiting, abdominal pain
Fainting or a drop in blood pressure after a sting, a drug or food
Any reaction after an injection, vaccination or new medication
A known allergy to bee or wasp stings — even if symptoms look mild at first

What not to do

Do not wait for antihistamines to work when the throat is involved
Do not give anything by mouth if swallowing is affected
Do not let the person stand or walk — sudden collapse is common
Do not leave them alone, even if the symptoms improve

What the crew does

Adrenaline, corticosteroids and antihistamines by injection
Oxygen, inhaled bronchodilators, intravenous fluids for low blood pressure
Airway support and readiness to intubate
Admission for observation — anaphylaxis frequently relapses

This page is for information and does not replace a medical examination. If the condition worsens, call the crew: +7 (985) 887-82-52.

This page in Russian: Russian version.

Questions

Where can I get an adrenaline auto-injector in Russia?

Auto-injectors are not reliably available in Russian pharmacies; allergists usually prescribe an ampoule of adrenaline with a syringe for the emergency kit. Ask your allergist to write the kit and show you how to use it.

How much does a call-out for an allergic reaction cost in Moscow?

Call-out 6,000 ₽ inside the MKAD; injections, infusion and oxygen by the price list.

Swelling went down on its own — do I still need to be seen?

If the tongue or throat was involved, yes: a second wave several hours later is common and can be worse than the first.