Managing allergy and anaphylaxis in the workplace

August 25, 2026

Brenniston calendar page illustration of what to do in an allergy and anaphylaxis emergency at work.

Allergic reactions can happen in any Australian workplace.

Food, medication, insect bites and stings, latex and other allergens can trigger reactions ranging from mild symptoms such as hives or swelling to a rapidly developing medical emergency.

Recognising the difference matters because anaphylaxis can become life-threatening within minutes.

Anaphylaxis is the most severe type of allergic reaction. It requires immediate treatment with an adrenaline auto-injector device and may be fatal if treatment is delayed.

For workplace first aiders, the priority isn’t to diagnose the allergy or determine exactly what caused it. The priority is to recognise the warning signs, follow the person’s ASCIA Action Plan where available, administer adrenaline when indicated, call Triple Zero (000) and stay with the person until emergency help arrives.

ASCIA’s current guidance emphasises that when anaphylaxis is suspected, there’s no time to wait and see. If in doubt administer an auto-injector adrenaline device. Start CPR if there’s no normal breathing or if the person is unresponsive.

Why anaphylaxis can turn into a workplace emergency so quickly

Anaphylaxis affects breathing and circulation, and symptoms can worsen rapidly.

Importantly, a person doesn’t necessarily need to develop a rash or other obvious skin reaction before anaphylaxis is recognised. Sudden breathing difficulty, swelling of the tongue or throat, persistent dizziness or collapse can be enough to indicate a severe allergic reaction.

First aiders shouldn’t wait for every possible symptom to appear. If there’s a known or suspected allergen exposure and a red-flag symptom develops, the response needs to begin immediately.

The person’s own ASCIA Action Plan should be followed whenever one is available. Workplaces should also make sure relevant workers know where action plans and adrenaline devices are kept and how to access them quickly.

Mild or moderate allergic reaction

Brenniston calendar page illustration of what to do in an allergy emergency at work.

A mild or moderate allergic reaction does not necessarily mean anaphylaxis is developing, but it still requires attention.

Symptoms can include swelling of the lips, face or eyes, hives or welts, tingling of the mouth and, in some circumstances, abdominal pain or vomiting. Mild or moderate symptoms may also occur without progressing to anaphylaxis, but they should be monitored because anaphylaxis can occur without a preceding mild reaction.

1. Stay - Stay with person and call for help

2. Locate and prepare - Locate ASCIA Action plan and adrenaline device, follow and prepare to administer

3. Call - Phone family/emergency contact

If someone with known asthma and food, insect or medication allergy has sudden breathing difficulty, give adrenaline device first, then asthma puffer.

The key point is to remain with the person rather than leaving them alone while looking for assistance. If symptoms change, the situation may have become anaphylactic and the response must escalate immediately.

Severe allergic reaction (anaphylaxis)

Brenniston calendar page illustration of what to do in an anaphylaxis emergency at work.

Anaphylaxis should always be treated as a medical emergency.

ASCIA identifies signs including difficult or noisy breathing, swelling of the tongue, swelling or tightness in the throat, wheeze or persistent coughing, difficulty talking or a hoarse voice, persistent dizziness or collapse, and a pale and floppy appearance in young children.

1. Lay Down - Lay person flat. If breathing is difficult sit them up with legs outstretched. DO NOT sit them on a chair, stand or walk. Hold young children flat, not upright

2. Give - Give the adrenaline device as shown on the label

3. Triple Zero - Call Triple Zero (000) for an ambulance

4. Call - Phone family/emergency contact

5. Wait 5 minutes - If there is no improvement or reaction is getting worse, give another adrenaline device if available

Don’t allow the person to stand or walk. During anaphylaxis, blood pressure can fall rapidly and standing or walking can make the situation worse.

If the person is unconscious or pregnant, the recovery position is appropriate. If breathing is difficult, they may sit with their legs outstretched.

Why adrenaline is the most important first aid treatment

When anaphylaxis occurs, adrenaline is the critical first-line treatment.

It works rapidly to counter the dangerous effects of anaphylaxis on the airway, breathing and circulation.

ASCIA’s current guidance is clear that delayed administration of adrenaline is associated with fatal anaphylaxis and adrenaline is the only treatment that shouldn’t be delayed while waiting to see whether symptoms improve.

This is why an adrenaline device should be readily accessible when a worker has been prescribed one. Staff who may need to assist should also be familiar with the device and its instructions before an emergency occurs.

The specific device used should always be administered according to its instructions. ASCIA currently provides guidance for several adrenaline devices approved for use in Australia, including EpiPen, Anapen and neffy.

What if the person has asthma as well as an allergy?

Asthma and anaphylaxis can sometimes produce similar breathing symptoms, which can make an emergency harder to recognise.

However, ASCIA provides instruction for people with known asthma and an allergy to food, insects or medication.

If they develop sudden breathing difficulty, including wheezing, persistent coughing or a hoarse voice, following possible exposure to an allergen, the adrenaline device should be given first, followed by the asthma reliever. This applies even when there are no other reactions to the skin, eyes or mouth.

For workplace first aiders, this is an important distinction. Breathing difficulty after allergen exposure shouldn’t automatically be assumed to be an asthma attack.

Why positioning the patient matters during anaphylaxis

Positioning might seem like a minor detail during an emergency, but it can make a significant difference.

A person experiencing anaphylaxis shouldn’t be allowed to stand or walk, even if they say they feel better. Lying flat helps maintain blood flow to the heart, whereas standing or walking can contribute to a dangerous fall in blood pressure.

If breathing is difficult, ASCIA advises allowing the person to sit with their legs outstretched rather than sitting upright on a chair. Young children should be held flat rather than upright. An unconscious person should be placed in the recovery position.

These instructions are worth including in workplace first aid training because they are easy to overlook when people are under pressure.

When should workers call Triple Zero (000)?

If anaphylaxis is suspected, Triple Zero (000) should be called for an ambulance immediately.

Don’t wait to see whether the adrenaline shot has worked before seeking emergency assistance.

The person should be transferred to hospital for medical assessment and observation even if their symptoms appear to improve after adrenaline. ASCIA’s current first aid guidance recommends hospital observation following anaphylaxis because symptoms can recur.

A workplace emergency procedure should make it easy for staff to provide the exact location of the incident, describe the person’s symptoms and advise emergency services that anaphylaxis is suspected.

What should a workplace do after the emergency?

The response shouldn’t end when the ambulance leaves.

Once the immediate emergency is over, the workplace should review what happened and determine whether its first aid plan was enacted as intended. Suggested review questions include:

Was the adrenaline device easy to locate?
Could workers find the ASCIA Action Plan quickly?
Was there someone appointed to call Triple Zero (000)?
Was the first aid response coordinated?

This review can identify simple improvements that may make the next emergency easier to manage.

It’s also important to replenish used emergency equipment and ensure any workplace-held resources remain within their expiry dates and are stored according to the manufacturer’s requirements.

How Australian workplaces can prepare before an allergic emergency

Good emergency response begins well before someone develops symptoms.

Australian workplaces should consider allergy and anaphylaxis as part of their first aid risk assessment, particularly where workers, students, residents, customers or visitors may have known severe allergies or where exposure to likely allergens is foreseeable.

Safe Work Australia’s first aid guidance recommends that workplaces have appropriate first aid equipment, trained first aiders and arrangements based on the hazards and circumstances of the workplace.

Practical preparation can include ensuring:

First aiders understand the signs of anaphylaxis
Emergency contact procedures are clear
Workers know where first aid equipment is located
Relevant ASCIA Action Plans can be accessed quickly
Prescribed adrenaline devices are readily available to the person who needs them
First aiders understand correct positioning
Workers know how to call Triple Zero (000)
Emergency procedures are reviewed and practised regularly

Training is particularly valuable because anaphylaxis can be a confronting and time-critical emergency that demands a clear, rehearsed response from anyone present.

People who have practised their response are more likely to act promptly rather than hesitate.

Conclusion

An allergy and anaphylaxis emergency can happen unexpectedly at work, but the response doesn’t have to be unpredictable.

The most important skill is recognising when an allergic reaction has become anaphylactic and acting without delay. Follow the ASCIA Action Plan for Anaphylaxis (RED), give the adrenaline device when indicated, call Triple Zero (000), position the person correctly and remain with them until emergency assistance arrives.

For Australian workplaces, preparedness is about more than keeping first aid supplies on a shelf. It means ensuring workers understand the warning signs, know where emergency resources are located and have the confidence to act when minutes matter.

A well-prepared workplace cannot prevent every allergic reaction. But it can make sure that when one occurs, the response is fast, informed and focused on giving the person the best possible chance of recovery.