Guidelines reviewed
Anaphylaxis
What RCUK, Anaphylaxis UK, NHS and St John Ambulance each publish on anaphylaxis – reviewed, compared and summarised for first aid instructors.
Guidelines reviewed
Last updated 30 April 2026
Resuscitation Council UK (RCUK)
To view anaphylaxis guidelines for first aiders, click the link and open the Medical Emergencies tab: Anaphylaxis Guidelines for First Aiders
To view all anaphylaxis search results including guidance for healthcare professionals click here: Resus Council UK – All search results for Anapahylaxis
Guidelines published 27 October 2025
Published 27 Oct 2025
Anaphylaxis UK
Anaphylaxis UK is a UK-wide charity that provides trusted, evidence-based information, training, and support for people at risk of serious allergic reactions (anaphylaxis).
NHS Conditions – Anaphylaxis
NHS guidance on anaphylaxis was last reviewed on 21 June 2023
Next review due: 21 June 2026
Reviewed 21 Jun 2023 · next review Jun 2026
St John Ambulance (SJA)
Clinically reviewed: 25/04/2025
Summary
All sources are consistent on the core protocol:
- Give adrenaline early
- Call 999
- Lie the person flat with legs raised
- Give a second dose if there is no improvement after 5 minutes.
Where the sources differ, the comparison table notes it.
How the sources compare
Point-by-point agreement across the four published sources. A tick means the source includes that point.
| Point | Anaphylaxis UK | NHS Conditions | SJA | RCUK | Notes |
|---|---|---|---|---|---|
| Recognition | |||||
| Airway – swelling in the throat, tongue or upper airways, hoarse voice, difficulty swallowing | Agrees | Agrees | Agrees | Agrees | |
| Breathing – sudden onset wheezing, breathing difficulty, noisy breathing, persistent cough | Agrees | Agrees | Agrees | Agrees | |
| Circulation – dizziness, feeling faint, sudden sleepiness, confusion, pale clammy skin, loss of consciousness or collapse | Agrees | Agrees | Agrees | Agrees | |
| Treatment | |||||
| Give adrenaline | Agrees | Agrees | Agrees | Agrees | |
| Call 999 | Agrees | Agrees | Agrees | Agrees | If alone, casualty advised to administer adrenaline and then call 999 |
| Lie the person flat with legs raised | Agrees | Agrees | Agrees | Agrees | |
| Give a second dose if there is no improvement after 5 minutes | Agrees | Agrees | Agrees | Agrees | |
Recognition
Airway – swelling in the throat, tongue or upper airways, hoarse voice, difficulty swallowing
- Anaphylaxis UK agrees
- NHS Conditions agrees
- SJA agrees
- RCUK agrees
Breathing – sudden onset wheezing, breathing difficulty, noisy breathing, persistent cough
- Anaphylaxis UK agrees
- NHS Conditions agrees
- SJA agrees
- RCUK agrees
Circulation – dizziness, feeling faint, sudden sleepiness, confusion, pale clammy skin, loss of consciousness or collapse
- Anaphylaxis UK agrees
- NHS Conditions agrees
- SJA agrees
- RCUK agrees
Treatment
Give adrenaline
- Anaphylaxis UK agrees
- NHS Conditions agrees
- SJA agrees
- RCUK agrees
Call 999
- Anaphylaxis UK agrees
- NHS Conditions agrees
- SJA agrees
- RCUK agrees
If alone, casualty advised to administer adrenaline and then call 999
Lie the person flat with legs raised
- Anaphylaxis UK agrees
- NHS Conditions agrees
- SJA agrees
- RCUK agrees
Give a second dose if there is no improvement after 5 minutes
- Anaphylaxis UK agrees
- NHS Conditions agrees
- SJA agrees
- RCUK agrees
FAQs and Resources
What is EURneffy and how do I order a trainer device?
EURneffy® (also known as Neffy) is a needle-free adrenaline nasal spray approved by the MHRA in July 2025 for emergency treatment of allergic reactions (anaphylaxis) in the UK. It is intended for adults and children weighing 30kg or more, offering a non-invasive alternative to auto-injectors.
Key Details
Usage: It is designed for single-dose administration directly into one nostril, allowing for rapid absorption, with a second dose potentially required if symptoms do not improve.
For further details, go to: EURneffy.co.uk
Click here to order a trainer device: EURneffy Trainer Device
Download Allergy Action Plans
BSACI Standards of Care Committee (SOCC) has developed Allergy Action Plans for adults and children at risk of anaphylaxis.
The Allergy Action Plans have been developed with the national allergy patient charities Allergy UK and Anaphylaxis UK.
Click to view and download: BSACI Allergy Action Plans
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