If a rash suddenly spreads over the body with trouble breathing or dizziness, treat it as anaphylaxis, and call 120 (China's ambulance number) at once and say so clearly

In a real emergency, call 911 first, then read this.

Cost

Free. For people with a known severe allergy, keeping an epinephrine pen of their own costs money, and it is a prescription drug.

What you get

Epinephrine is the drug of first choice (first-line drug) for anaphylaxis of grade 2 and above, and the guideline gives it a strong recommendation. Allergy pills and steroids work slowly and cannot take its place

Notes

This allergy guideline (EAACI) itself says that in this field "the evidence mostly stays at a very low level." It gives a strong recommendation because the benefit far outweighs the risk, not because of large trials. Epinephrine is a prescription drug in China, and ordinary people usually don't have it. What you can do is call 120 and say "suspected anaphylaxis," so the ambulance brings the drug. If you have had a severe allergic reaction once, ask a doctor to prescribe an auto-injector pen, and learn to inject into the middle of the outer thigh (the outer side, slightly toward the front), which can be done through trousers.

Evidence grade

B : Supported by research but without a precise number, or based on small or single studies.

Sources

1. 中国医药教育协会等 (2022). 过敏性休克急救临床实践指南（2020）. Frontiers in Pharmacology：「Epinephrine is the first-line medicine in GRADE II to IV anaphylaxis」「Intramuscular epinephrine should be injected in the mid-anterolateral thigh」，成人肌注上限 0.5 mg、14 岁以下 0.3 mg，无反应可每 5–15 分钟重复一次. https://doi.org/10.3389/fphar.2022.845689
2. Muraro A, et al. (2022). EAACI guidelines: Anaphylaxis (2021 update). Allergy. https://doi.org/10.1111/all.15032

Translated from the Chinese original. Original book, section 13, tip 15. Content may be out of date and rules differ by place. When you actually deal with an agency, a doctor or a court, follow what local officials, doctors and lawyers tell you. Disclaimer