A health training module for school students. - Presented by PRSM Allergy Foundation
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Welcome!
What Would You Do?
Imagine your friend suddenly can’t breathe after eating lunch. Their face is swelling and they look terrified. Do you know what to do?
This module will teach you to recognize a life-threatening allergic reaction and take the right steps to help. You could save a life.
~10 minutes10 sectionsKnowledge checks
What You’ll LearnBy the end of this module you’ll know how to spot anaphylaxis, what to do immediately, how the EpiPen works, why the hospital is always necessary, and how to support a friend who has a severe allergy.
Meet Anna
Anna’s Story
Anna is a 14-year-old student with a known peanut allergy. At lunch, she grabbed what looked like a plain granola bar from the cafeteria line. A few minutes after taking a bite, something felt very wrong.
Her lips and tongue began to swell. Her throat felt like it was closing. Red, itchy bumps — hives — broke out across her chest and arms. She turned to her friend and whispered, “I can’t breathe… my throat is closing up.”
Her face went pale. She became dizzy and confused. She had an EpiPen in her backpack — prescribed by her doctor for exactly this situation.
What’s happening to Anna?Anna is having anaphylaxis — a sudden, severe, life-threatening allergic reaction. Her body is overreacting to the peanut protein in that granola bar. Without fast action, this can become fatal within minutes.
Quick Check: Anna’s Story
Think about what you just readBefore we go deeper, let’s make sure the key ideas from Anna’s story landed. Answer both questions below.
Question 1 of 2
Which symptom Anna experienced is the most immediately life-threatening?
Question 2 of 2
Anna’s reaction was triggered by peanuts in a granola bar she didn’t know contained peanuts. What does this tell us about severe allergies?
What Is Anaphylaxis?
Anaphylaxis (say it: an-a-fi-LAX-iss) is the most serious kind of allergic reaction. It can affect the whole body all at once and can be fatal within minutes if not treated.
How does it happen?When someone with a severe allergy is exposed to their trigger (like peanuts, bee stings, or certain medications), their immune system treats it as a dangerous invader and floods the body with chemicals. These chemicals cause the airways to swell, blood pressure to drop, and multiple body systems to shut down rapidly.
Common triggers include:
Food allergens — especially peanuts, tree nuts, shellfish, fish, milk, and eggs
Insect stings (bees, wasps)
Certain medicines (like penicillin)
Latex (a type of rubber)
What happens if anaphylaxis goes untreated?Without epinephrine, the airway can swell completely shut, blood pressure can collapse, and the heart can stop. Death can occur within 15–30 minutes of symptom onset. This is not an overreaction — it is a true medical emergency every single time.
How fast can it happen?Symptoms can begin within seconds to minutes of exposure. This is why speed matters more than anything else.
Mild Reaction vs. Anaphylaxis
Not every allergic reaction is an emergency — but knowing the difference can save a life. The key is how many body systems are affected, and how fast.
✓ Mild Allergic Reaction
Localized hives or itching
Runny nose or sneezing
Watery, itchy eyes
Mild stomach discomfort
Symptoms in one area only
No breathing difficulty
Person can speak normally
⚠ Anaphylaxis — Emergency!
Throat tightening or closing
Difficulty breathing or wheezing
Swelling of lips, tongue, or face
Dizziness, fainting, confusion
Symptoms in multiple body systems
Rapid or weak pulse
Pale or bluish skin color
The Golden RuleIf someone has trouble breathing AND hives or swelling after eating or being stung — treat it as anaphylaxis. Do NOT wait to see if it gets worse. Acting too early is always safer than acting too late.
What happens if anaphylaxis is left untreated?
0–2m
Symptoms beginHives, swelling, throat tightness, dizziness appear within seconds to 2 minutes of exposure.
Critical danger zoneAirway may close almost completely. Person may lose consciousness from lack of oxygen or dangerously low blood pressure.
15–30m
Potentially fatalWithout epinephrine, the body cannot recover on its own. Death from cardiac arrest or oxygen deprivation can occur within 15–30 minutes.
The bottom lineAnaphylaxis cannot fix itself. It will not “calm down” without treatment. Every minute without epinephrine matters.
Recognize the Warning Signs
Anaphylaxis usually affects more than one part of the body at the same time. Look for these signs:
Breathing trouble Tight throat, wheezing, struggling to breathe
Swollen lips or tongue Throat closing up, trouble swallowing
Hives or rash Red, itchy welts suddenly covering the skin
Dizziness or confusion Feeling faint, slurring words, looking pale
Nausea or vomiting Sudden stomach pain, cramping, throwing up
Bluish lips or skin A sign the body isn’t getting enough oxygen
Key ruleIf someone is having trouble breathing AND has swelling or hives after eating or being stung — treat it as anaphylaxis immediately. Don’t wait to see if it gets worse.
Quick Check: Mild vs. Anaphylaxis
Question 1 of 2
Your friend eats a cookie and shortly after develops some hives on his right arm. They can breathe and speak normally. What is this most likely?
Question 2 of 2
Why is it so dangerous to wait and see if anaphylaxis improves on its own?
Quick Check: Recognizing Anaphylaxis
Question 1 of 2
Your classmate just got stung by a bee. Which combination of symptoms would make you treat it as anaphylaxis?
Question 2 of 2
Anaphylaxis affects ________ of the body at once, which is what makes it different from a regular allergic reaction.
Spot. Shot. Dial.
Remember this motto
Spot
→
Shot
→
Dial
Epinephrine first — then call 911. Every second counts.
1
Spot — recognize it fastHives + swelling + breathing trouble = anaphylaxis. Don’t wait to be certain. Yell for a teacher or adult immediately: “This is an emergency — someone is having a severe allergic reaction!”
2
Shot — give epinephrine firstUse the EpiPen or Auvi-Q right away — before calling 911. This is the most critical action. Do not wait.
3
Dial — call 911 immediately after the shotPoint at a specific person: “You — call 911 right now.” Don’t assume someone else will do it.
4
Stay with the person — do not leave them aloneKeep them calm. If they feel faint, help them lie flat with legs elevated. If breathing is difficult, let them sit up.
The Nurse’s Office
Schools keep epinephrine auto-injectors (EAIs) in the nurse's office. Know exactly where your school nurse's office is right now — before you ever need it. Many schools also have trained staff throughout the building who carry EAIs. Ask your teacher today who those people are and where they are located.
Why shot before dial?Epinephrine is the only treatment that can stop anaphylaxis. Giving the shot first — even 30 seconds sooner — can be the difference between life and death. 911 is critical, but the shot cannot wait.
Knowledge Check
During a school emergency, where is the FIRST place you should look for an epinephrine auto-injector?
The Epinephrine Auto-Injector (EAI)
An epinephrine auto-injector is a device that delivers a pre-measured dose of epinephrine (also called adrenaline) into the outer thigh. It is the only first-line treatment for anaphylaxis — brands include the EpiPen and the Auvi-Q.
What epinephrine doesIt rapidly opens up the airways, reduces swelling, raises blood pressure, and slows the allergic response — buying critical time until emergency services arrive.
EAI (Epinephrine) vs. Antihistamines (like Benadryl):
EAI (Epinephrine)
Antihistamine (Benadryl)
Works in 1–2 minutes
Works in 30–60 minutes
Treats life-threatening symptoms — airway swelling, low BP
Only treats mild symptoms — hives, sneezing
Correct treatment for anaphylaxis
Not sufficient — may give false security
Never substitute Benadryl for an EAI during anaphylaxis.By the time an antihistamine kicks in, it may be too late. The airway cannot wait 30–60 minutes.
Watch: How to Use an Epinephrine Auto-Injector
Watch the short video to learn how to use a common epinephrine auto-injector: the EpiPen.
EpiPen
Why the Hospital — Even After the EpiPen?
The EpiPen helped Anna breathe again. She’s starting to feel better. So… she can just go back to class, right? Absolutely not.
The Biphasic ReactionA biphasic reaction is a second wave of anaphylaxis that can happen hours after the first reaction — even after the EpiPen has been used and the person feels completely fine. It can be as severe or even worse than the first reaction.
1
The EpiPen wears offEpinephrine lasts only about 15–20 minutes. Without hospital monitoring and further treatment, symptoms can return.
2
The hospital can give additional treatmentDoctors can provide IV medications, oxygen, and monitoring that aren’t available at school.
3
Every case of anaphylaxis requires 911Even if the EpiPen worked. Even if they feel better. No exceptions.
The rule is simple:EpiPen → Call 911 → Go to the hospital. Always. Every time.
Knowledge Check
Anna used her EpiPen and says she feels much better. What should happen next?
Your Role & Supporting Anna
You may not know how to use an EpiPen. That’s okay. You can still save a life.
The most powerful thing any bystander can do:Recognize what’s happening, call for help loudly and clearly, and stay with the person so they are not alone.
✓
Yell for help the moment you suspect anaphylaxisDon’t wait until you’re sure. Acting too early is far safer than acting too late.
✓
Send a specific person for helpPoint and say: “You — go get a teacher.” Vague requests often go unanswered.
✕
Don’t leave them alone to go get help yourselfA person in anaphylaxis can lose consciousness quickly. Never leave them unattended.
After the emergency — how to support Anna:
Remind her it wasn’t her fault. The peanuts were mislabeled — she couldn’t have known.
Don’t gossip or make fun of what happened. Serious medical events aren’t content for social media.
Learn about her allergy so you can help her avoid triggers in the future.
Ask how she’s doing — not just right after, but in the days that follow.
RememberLiving with a severe food allergy requires constant alertness. Your understanding and support makes school a safer, less stressful place for classmates like Anna.
Knowledge Check
You’re the only person near Anna during her reaction and you don’t know how to use her EpiPen. What’s the BEST thing to do?
You Did It!
Module Complete
You now have the knowledge to recognize anaphylaxis and take life-saving action. In an emergency, confident, fast action is the difference between life and death.
Recognizer
First Responder
EAI Aware
Ally
Take this survey to evaluate your understanding of anaphylaxis.