Anaphylaxis in a restaurant: what staff should do in the first minutes
By the Menulta editorial team · Facts checked 15 October 2026 · Updated 15 October 2026
The short answer
If a guest shows signs of anaphylaxis, such as difficulty breathing, swelling of the throat or tongue, wheezing, a hoarse voice, dizziness or collapse, call the emergency number immediately (112 in the EU), help the guest use their adrenaline auto-injector if they have one, and do not leave them alone. Keep them lying down with legs raised, or sitting up if breathing is difficult. A second dose may be given after five minutes if there is no improvement and a second injector is available.
Recognising anaphylaxis
Anaphylaxis is a severe, potentially life-threatening allergic reaction that usually develops within minutes of eating the trigger food, though it can take longer. Signs can include:
- Airway: swelling of the tongue or throat, difficulty swallowing or speaking, a hoarse voice.
- Breathing: wheezing, persistent cough, noisy or difficult breathing.
- Circulation: feeling faint or dizzy, pale or clammy skin, confusion, collapse or unconsciousness.
- Often, but not always, skin symptoms such as hives, flushing or swelling, and stomach pain or vomiting.
What to do: the first minutes
| Step | Action |
|---|---|
| 1 | Call 112 (or the local emergency number) and say 'anaphylaxis' |
| 2 | Help the guest use their adrenaline auto-injector, into the outer thigh, through clothing if needed |
| 3 | Lie them down with legs raised; if breathing is difficult, let them sit up; if pregnant, lie on the left side |
| 4 | Do not let them stand or walk, even if they feel better |
| 5 | Stay with them; send someone to meet the ambulance |
| 6 | If no improvement after 5 minutes and a second injector is available, give the second dose |
| 7 | If they stop breathing, start CPR if trained |
Adrenaline auto-injectors
People at risk of anaphylaxis are usually prescribed adrenaline auto-injectors, often known by brand names such as EpiPen or Jext, and are advised to carry two. Each brand works slightly differently, and instructions are printed on the device. Staff should know how to help a guest use one: remove the safety cap, press firmly into the outer thigh and hold for the time stated on the device. Adrenaline can be given through clothing.
Restaurants generally cannot use an injector prescribed to someone else, and rules on businesses holding spare auto-injectors vary by country. Follow your national guidance.
What not to do
- Do not wait to see if symptoms improve before calling for help.
- Do not send the guest to the bathroom or outside alone.
- Do not let them stand up suddenly or walk to an ambulance.
- Do not rely on antihistamines to treat anaphylaxis; adrenaline is the first-line treatment.
- Do not try to make them vomit.
Afterwards
Even if the guest seems to recover after adrenaline, they must go to hospital, because symptoms can return. Once the emergency is over, record what happened: what the guest ate, what they told staff about their allergy, what the allergen record said, who prepared and served the dish, and the timeline. Keep the remaining food if possible. Review the incident with the team, identify the cause and fix the system. Cooperate with any investigation by the authorities.
Preparing your team
Include anaphylaxis in allergen training. Make sure every shift has staff who know the signs and steps, display the emergency number and your address near the phone, and practise the response occasionally, as you would a fire drill. First aid training that includes anaphylaxis is valuable for managers and supervisors.
Milder reactions
Not every reaction is anaphylaxis. A guest may develop hives, itching, a tingling mouth or mild stomach upset. Stay with them, stop them eating more of the food, and ask whether they have medication. Watch closely, because mild symptoms can progress to anaphylaxis, sometimes quickly. If any airway, breathing or circulation symptoms appear, treat it as anaphylaxis and call for help immediately.
Information for the ambulance crew
When the ambulance arrives, tell the crew what the guest ate, when symptoms started, what symptoms you saw, when adrenaline was given and how many doses. If possible, give them the dish's allergen information or the packaging of any bought-in product. Clear information helps them treat the guest quickly.
Sources
This guide is general information, not medical or legal advice. Guests with an allergy should follow their doctor's advice. Operators should confirm their own setup with their food safety adviser or local authority.