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The reaction begins within seconds or minutes after exposure to the allergen. Symptoms of an anaphylactic reaction include the following:  Pale skin, possibly flushed or reddened areas, hives, itching, and swelling at the site of exposure.  Feeling of warmth.  Difficulty swallowing, sensation of having a lump in your throat.  Difficulty breathing, coughing, wheezing, and chest tightness or discomfort.  Swelling of the tongue and mouth area, nasal congestion, and facial swelling.  Dizziness, light headedness, anxiousness, and slurred speech.  Abdominal pain, nausea, vomiting, and diarrhea.  Palpitations, and a weak and rapid pulse. Anaphylaxis is a medical emergency, will require expert medical attention, and possibly hospitalization.  Anaphylaxis can lead to death if it is not treated immediately. Stay on the line with emergency services for further instructions as you administer treatment. Do not delay in seeking emergency medical treatment, even if symptoms appear mild. In some cases, the reaction may be mild at first, then reach a serious and life-threatening level several hours after exposure. The initial reaction involves swelling and itching at the site of exposure. For an insect sting, this will occur on the skin. For a food or drug allergy, the swelling will likely begin in the mouth and throat area, which can quickly interrupt the ability to breathe. Ask the person if they have an epinephrine autoinjector, such as an EpiPen. The shot is usually administered in the thigh.  This is a shot that administers a dose of life-saving epinephrine to slow down the reaction, and is frequently carried by people with known food and bee sting allergies.  Do not assume this injection will be enough to completely stop the reaction. Proceed with treatment accordingly, including seeking emergency medical attention. Try to determine the cause of the reaction.  Common allergies that can cause life-threatening anaphylactic reactions include bee or wasp stings, insect bites or stings such as fire ants, food items including peanuts, tree nuts, shellfish, and soy or wheat products. If the person is unable to speak or respond, check for a medical alert necklace, bracelet, or wallet card.  If the cause is from an insect or bee sting, scrape the stinger from the skin using something firm, like a fingernail, key, or credit card.  Do not remove the stinger with tweezers. This will squeeze more venom into the skin. Position the person flat on the ground or floor. Do not place a pillow under their head since this can interfere with their breathing.  Do not give the person anything to eat or drink.  Raise their feet about 12 inches off the ground, and cover the person with something warm such as a coat or blanket.  Loosen any restrictive clothing such as belts, neck ties, buttoned pants, collars or shirts, shoes, and jewelry around the neck or wrist. If an injury is suspected to the head, neck, back, or spine, do not raise their legs, just let the person remain flat on the ground or floor. To prevent choking and maintain their airway, roll the person on their side if they begin to vomit or if you notice blood in the mouth. Take precaution to prevent further damage if a spine injury is suspected. Get help to gently log-roll the person onto his or her side by keeping the head, neck, and back in as straight a line as possible. Even if the person is breathing on their own, continue to monitor the rate of respirations and the pulse rate every few minutes. Also monitor the person’s level of consciousness every few minutes until the paramedics arrive. Only administer  CPR if you are trained to do so. An untrained person may do serious harm to someone by attempting CPR.  Only trained people should administer CPR to adults,  children, and  infants, due to the risk of serious and life-threatening injury. The American Red Cross has recently implemented new protocols for administering CPR. It is important that only people trained in the new methods, and in the use of an AED if available, take charge of administering those procedures. Continue to talk to the person in a calm and reassuring manner, monitor their condition, and watch closely for changes. The medical professionals will want an update from you on your observations and steps you have taken to treat this medical emergency.

Summary:
Recognize the symptoms of an allergic reaction. Call 911 or your local emergency services number. Inject epinephrine. Talk to the person in a calm and reassuring manner. Proceed with steps to prevent shock. Roll the person on their side if they begin to vomit. Continue to maintain a clear airway and monitor respirations and circulation. Start CPR if necessary. Stay with the person until the paramedics arrive.