Signs and Symptoms - Anaphylaxis

Today I was asked by a bright physician who I respect at a conferance in Canada about signs and symptoms as some of his associates were not sure what was and was not a sy sx. As a futher note he knew, they did not -- So here is our best most current information

Common to rare signs and symptoms of Anaphylaxis with notes.
Generally accepted that if any two are present, your patient is anaphylactic.


  1. Skin:
    1. redness, hives, swelling, itching
    2. 90% in USA population
    3. Taiwan study showed this to be less than 25% in their population. This is NOT a required sign.
  2. Respiratory (upper):
    1. tongue/throat swelling
    2. larynx swelling
    3. difficulty talking or swallowing
    4. stridor, respiratory distress.
  3. Respiratory (lower):
    1. cough, wheezing,    
    2. SOB, WOB, respiratory distress.
  1. Cardiovascular:
    1. pallor, dizziness, hypotension, tachycardia
    2. loss of consciousness
    3. systolic BP below 90. (From a wilderness medicine standpoint this is easy to do as normo-thermic patients are recognized as having pedal pulses or warm feet if their systolic is 90 or greater.)
  2. Gastrointestinal-*
    1. nausea, vomiting, abdominal cramping,bowel incontinence
      or pain.
  3. Genitourinary-*
    1. uterine cramping
    2. urinary urgency.

*While 5 and 6 are rare there are numerous examples of them, so do not over look them.

  1. Now being exposed to previously know anaphylactic agent.