Q: I’ve read that you’re supposed have a person lie down in an anaphylactic reaction after giving epinephrine. Why is that?
Dr. Sharma: When a person is experiencing anaphylaxis, it is recommended to have him or her lie down with the legs elevated.
This is done to ensure adequate blood flow to the vital organs. Also, this position helps to prevent a severe drop in blood pressure, which can sometimes occur in a severe reaction.
During anaphylaxis, the release of allergic mediators, or chemicals like histamine, can cause the blood vessels to become “leaky.” As a result, there can be massive fluid shifts out of the blood vessels, causing poor blood flow and decreased blood pressure.
When Not to Lie Down
It’s important to note that if someone is having breathing difficulty, he or she may not tolerate lying down. If that’s the case, then sitting up with legs elevated would be advised.
Finally, if the person is experiencing vomiting as one of the reaction symptoms, he or she should be placed on their side while lying down, to prevent choking.
Dr. Sharma is an allergist, clinical researcher and associate professor of pediatrics. He is Chief of the Division of Allergy and Immunology at Children’s National Medical Center in Washington D.C. and Director of the Food Allergy Program. Questions submitted will be considered for answer on this site.
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