A severe allergic reaction with airway and/or breathing and/or circulation problems.


  • Food (commonest cause in children)
  • Latex
  • Exercise (ask if wheat or fish eaten just prior to exercise, as very rarely can be food – induced exercise anaphylaxis)
  • Drugs (no need to refer if single drug and alternative available eg penicillin allergy)
  • Venom induced (most commonly bee or wasp)


Refer all cases of anaphylaxis to Paediatric Allergy Clinic



Adrenaline Auto – Injectors:

There is good BSACI guidance on who should receive these at www.BSACI.org

In most cases where provoking allergen may be accidentally encountered again (or idiopathic), prescribe 2 adrenaline autoinjector when referring, due to small risk of recurrence in intervening wait for appointment.

Use the excellent information sheet at https://www.medicinesforchildren.org.uk/medicines/adrenaline-auto-injector-for-anaphylaxis/


Demonstrate with 'dummy' pen if available


Doses (BNFc)

If child < 15kg discuss with Allergy Consultant before prescribing 

If < 30kg prescribe 0.15 mg

If > 30kg prescribe 0.3mg (if Epipen, can switch to 0.3mg dose of same pen if > 26kg)


                           January 2022

Review Date               January 2023

Authors:                     Simon Bedwani, Consultant Paediatrician, RCHT

                                    Dr S Burns GP RMS