Ready to Act

By recognizing the signs of allergic reactions and anaphylaxis, and knowing how to use epinephrine, you can save a life.

The stakes have never been higher.

Food allergy isn’t a choice, a preference, or a “diet.” Food allergy is a disease of the immune system that can cause a life-threatening allergic reaction called anaphylaxis.

For the over 33 million people in the U.S. who live with food allergy, one bite can change everything, at any time.

Epinephrine is the ONLY drug that is effective at stopping anaphylaxis.

Think "Epi First, Epi Fast"—treating an allergic reaction with epinephrine is a lifeline! But too many people with food allergy don’t think they need epinephrine, don’t carry it, or are afraid to administer it.

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Do you know there is now a needle-free epinephrine option?

In a 2020 survey published in the Annals of Allergy, Asthma, & Immunology, 34% of those who had allergic reactions severe enough to warrant using an epinephrine auto-injector failed to do so.

They cited fear of needles as a one of their chief reasons.

In 2024, the FDA approved a nasal spray epinephrine device, giving people a needle-free option for the first time.

Learn About Epinephrine Options

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The list of lives lost keeps growing—these are just a few of their names.

Remember, food isn’t the enemy. The disease is.

Content Warning: food allergy reactions, death

In memory of Dominique Brown (34), 12/5/24
In memory of Hannah Glass (19), 11/10/24
In memory of Hannah Jacobs (13), 2/8/24
In memory of Orla Baxendale (25), 1/11/24
In memory of Dr. Kanokporn (Amy) Tangsuan (42), 10/5/23
In memory of Alison Pickering (23), 5/12/23
In memory of Matthew Briden (28), 6/30/22
In memory of Jagger Shaw (14) 5/7/22
In memory of Reese Langer (13), 5/20/21
In memory of James Atkinson (23), 7/10/20
In memory of Logan Lewis (20), 12/5/19
In memory of Wyatt Polachek (12), 11/30/19
In memory of Elijah Silvera (3), 11/3/17

Every 10 seconds, a food allergy reaction sends someone to the Emergency Room in the U.S.¹

Emergency treatment for anaphylaxis increased by 377% in just one decade.² More than 40% of children with food allergy have experienced a severe allergic reaction.³

^{1, 2, 3 — Citations can be viewed on FARE's}^{"Facts and Statistics"}^page.

How Can You Be Ready to Act?

Focus! Recognize Signs of Reactions and Anaphylaxis

Millions of people are at risk for a severe type of allergic reaction called anaphylaxis.

Anaphylaxis is most frequently caused by insect stings, medications, latex allergy, and food allergy.

Anaphylaxis is caused when someone ingests or comes into contact with their allergen, and their body’s immune system overreacts in a life-threatening way.

While any food can be an allergen, the most common (“Top 9”) allergens in the United States are peanuts, tree nuts, milk, eggs, wheat, soy, finned fish, shellfish, and sesame.

With food allergy, anaphylaxis typically comes from eating or drinking the allergen, or touching the allergen and then touching their eyes or mouth. Reactions can also happen from cross-contact, or even aerosolized exposure.

Symptoms can start within seconds of contact with a food allergen, or it can take up to two hours for symptoms to appear.

Sometimes, after initial symptoms recede, a second round of symptoms can occur without re-exposure to the allergen. This can happen between 1 and 48 hours after the first symptoms (or sometimes longer), even after treatment has been given, and is called a biphasic reaction.

Accidents happen. Anaphylaxis is scary. But you can recognize this emergency situation and feel empowered to react with confidence.

Look for any severe symptoms:

Shortness of breath, wheezing, repetitive cough
Pale or bluish skin, faintness, a weak pulse, or dizziness
Hoarse or tight throat, trouble breathing or swallowing
Significant swelling of tongue or lips
Many hives, all over the body, or widespread redness
Repetitive vomiting or severe diarrhea
A feeling that “something bad” is about to happen, anxiety or confusion

If someone is experiencing any one of these symptoms, it’s very likely they are experiencing anaphylaxis and you should act accordingly.

You should also look for more than one mild symptom:

An itchy, runny nose or sneezing
An itchy mouth
A few hives or itch on the skin
Mild nausea or discomfort

If someone is experiencing two or more of these symptoms, you should suspect anaphylaxis and proceed accordingly.

As you look for symptoms, try to talk to the person. If the person cannot talk, check for medical identification jewelry that identifies them as someone with allergy.

If YOU are experiencing the reaction, make sure to alert someone else, describe your symptoms, and indicate whether and where you carry epinephrine.

While it is true that allergic reactions can be mild or severe, a history of mild reactions doesn’t mean the reaction at hand won’t be severe. Take every reaction seriously.

Epinephrine is the only emergency treatment that can stop an anaphylactic reaction. Reactions may be treated through a combination of medications that includes steroids, antihistamines, and asthma medications such as bronchodilators (“rescue inhalers”), but lead with “Epi First, Epi Fast.”

Take Action! Provide “Epi First, Epi Fast” Treatment

Epi First, Epi Fast: every second counts with anaphylaxis.

Epinephrine is a very safe drug, so when in doubt, it is better to give it.

Ask the patient if they carry epinephrine; it may be in a purse or a backpack nearby.

If the patient cannot speak or is not carrying epinephrine, ask bystanders if they are carrying epinephrine.

Unassigned epinephrine may be available in spaces such as on airplanes, in schools, or public venues such as concert halls and sports stadiums.

FARE indexes resource sites for all current epinephrine delivery systems, including a new (2024) needle-free nasal spray option.

Watch a video demonstration of administering epinephrine as part of FARE’s “Save a Life” training, which is free and updated annually. Anxiety around using auto-injectors is common, but do not let a fear of needles stop you from using epinephrine—especially since now, there is a nasal spray option. You can save a life.

After you give epinephrine, call 911 (if no one has done so already) and request an ambulance with epinephrine be sent immediately. Not all ambulances carry epinephrine.

If the patient is not improving in five minutes, or they begin to improve but then get worse, you may need to give a second dose of epinephrine if one is available.

If epinephrine is not on hand, lay the person flat, raise their legs, and keep them warm. If breathing is difficult or they are vomiting, let them sit up or lie on their side. They may use a rescue inhaler to help with trouble breathing, if one is available. Help them stay calm.

When emergency personnel arrive, provide any details you can about what happened, any symptoms you noticed, and how epinephrine was provided.

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