Allergic reaction triage
Primary care triage for allergic reactions with immediate recognition of anaphylaxis risk and escalation triggers.
Last reviewed February 7, 2026
Red flags
- Airway compromise, respiratory distress, hypotension, or multisystem progression.
- Rapid symptom escalation after likely allergen exposure.
- Refractory symptoms or biphasic reaction concern after initial stabilization.
Assessment priorities
- Determine trigger exposure timing, symptom pattern, and airway involvement.
- Assess breathing, circulation, skin/mucosal findings, and GI symptoms rapidly.
- Clarify prior anaphylaxis history and epinephrine access.
Initial management
- Suspected anaphylaxis requires immediate IM epinephrine and 911 activation; see the allergic-reaction workflow for dosing and repeat treatment. Do not wait for skin findings or hypotension.
- Keep the patient supine with legs elevated where tolerated; do not allow standing/walking. Antihistamines and inhalers must not delay epinephrine or emergency transfer.
- For non-severe reactions, provide symptom control with close observation strategy.
- Document clear trigger-avoidance and emergency action instructions.
Follow-up and escalation
- Transfer suspected anaphylaxis for hospital assessment even after improvement; hospital teams determine observation duration.
- Escalate immediately for any airway, breathing, or circulation deterioration.
- Arrange allergy-focused follow-up for trigger confirmation and prevention planning.
References
- Public Health Agency of Canada Community anaphylaxis management (opens in a new tab)
- CSACI Immunotherapy Manual 2024, anaphylaxis management (opens in a new tab)
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