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Responding to an anaphylaxis emergency when there is limited access to an ambulance

ASCIA is aware that there is limited access to ambulances in some regions, due to issues related to the latest COVID-19 outbreaks, and in rural or remote settings. 

ASCIA's advice for people having anaphylaxis and their carers is as follows:

  1. Follow the ASCIA Action Plan for Anaphylaxis.
  2. Give an adrenaline (epinephrine) injector (EpiPen or Anapen) without delay. 
  3. Always call 000 (AU) or 111 (NZ) after giving adrenaline and take advice regarding emergency management.

Further adrenaline (if available) should be given when:

  • There is no response after five minutes.
  • Signs and symptoms of anaphylaxis continue to progress.
  • Signs and symptoms improve and then become worse again.

When there is limited or no access to an ambulance:

  • The person who has been called to help should communicate with emergency services and arrange for themselves or another responsible person to transport the person to a hospital or other medical facility.
  • Two people should ideally travel with the person having anaphylaxis, one to drive and the other to monitor their health.
  • Where possible, do not allow the person who is having anaphylaxis to walk or stand as this may make their symptoms worse.* 

*For safety and legal reasons the person having anaphylaxis needs to be seated in a vehicle so that they can wear a seatbelt. The seatbelt may need to be adjusted so that it is snug over the chest and lap if the seat is:

  • Reclined to make them as flat as possible.
  • Pushed back to allow space to elevate their legs. 

When there is limited access to an ambulance, people who are at risk of anaphylaxis, and their carers should also consider:

  • Taking extra care to reduce the risk of allergic reactions.
  • Always carrying two prescribed adrenaline injectors with you everywhere.
  • Discussing a plan before you are in an emergency situation.
  • Checking where the nearest hospital is located if you are going away on holidays.
  • If a third adrenaline injector is available, giving it 5 minutes after the second dose, if needed.

Patient and carer support is available from:

Allergy & Anaphylaxis Australia

Allergy New Zealand

ASCIA anaphylaxis information is available at  

This news item was issued on 11 January 2022 by the Australasian Society of Clinical Immunology and Allergy (ASCIA), the peak professional body for clinical immunology and allergy in Australia and New Zealand.