15 Minutes to Cardiac Arrest
Anaphylactic shock - medication - the most common trigger in adults
Whenever you hear of an anaphylactic reaction in children, food allergies usually come to mind. While food allergies are the most common trigger for children, the most common cause in adults is different — allergic reaction to medications.
Anaphylaxis is a severe allergic reaction that can progress into a life-threatening condition, caused by exposure or ingestion of something to which you are allergic. The immune system then overreacts. Symptoms involve multiple body systems including the skin, heart, stomach, and airways.
Symptoms of Anaphylaxis: Differences Between Adults and Children (1,3)
| Symptom Type | Children (esp. infants/toddlers) | Adults |
|---|---|---|
| Skin | Very common (hives, swelling, itching) | Very common |
| GI (vomiting/diarrhea) | Very common, especially in infants | Common |
| Respiratory | Wheezing, stridor, hoarse cry/voice, nasal stuffiness; more prominent in young children | Shortness of breath, wheezing, chest tightness, hoarse voice |
| Cardiovascular | Rare in young children; more in teens | Common (dizziness, hypotension, fainting, shock) |
| Behavioral | Sudden fussiness, sleepiness, agitation | Sense of doom, confusion |
| Throat symptoms | Trouble swallowing, drooling (infants) | Swelling, tightness, hoarse voice, trouble swallowing |
Children
Most Common Symptoms:
- Skin reactions: hives, itching, redness, swelling
- Gastrointestinal: vomiting, diarrhea, belly pain
- Respiratory: wheezing, coughing, hoarse voice, stridor (especially in pre-schoolers), trouble breathing, nasal stuffiness
- Throat: tightness, trouble swallowing, drooling (notably in infants)
- Behavioral: sudden fussiness, unusual sleepiness or crying in infants, agitation, or a feeling of impending doom
Less Common in Children:
- Cardiovascular symptoms (hypotension, fainting) are less frequently observed in young children and infants, partly due to under-recognition and less frequent blood pressure measurement
Adults
Most Common Symptoms:
- Skin: hives, itching, swelling, redness
- Respiratory: shortness of breath, wheezing, cough, chest tightness, hoarse voice, swelling of lips/tongue/throat
- Cardiovascular: dizziness, fainting, weak or rapid pulse, low blood pressure, paleness, slurred speech, confusion, chest pain, even loss of consciousness
- Gastrointestinal: nausea, vomiting, diarrhea, cramps, belly pain
- A "sense of doom" or extreme fear is often reported in adults right before a severe reaction
Adults are more likely than children to experience cardiovascular symptoms such as hypotension, shock, and loss of consciousness, and outcomes are more fatal. Symptoms may progress to anaphylactic shock more rapidly in adults, especially with medication or insect sting triggers. (2,3,4)
Given the most common cause of anaphylaxis in adults is medications leading to cardiac arrest; the average time to cardiac arrest is 15 minutes, this is a medical emergency that requires immediate intervention. (6)
Causes of Anaphylaxis (3,4,5)
| Cause of Anaphylaxis | Children (Est. % cases) | Adults (Est. % cases) |
|---|---|---|
| Food (Milk, wheat, eggs, peanuts, and tree nuts are most common) | 37-89.7% (MOST COMMON) | 13-33% |
| Medications (antibiotics, aspirin, NSAIDs) | 5-12% | 34% (MOST COMMON) |
| Insect Stings (bees, wasps, hornets, fire ants) | 5-13% | 15-25% |
| Idiopathic | Rare | 11-19.5% |
Key Takeaway
Epinephrine is the only medication that can reverse symptoms. A quick response by administering epinephrine could save your life — or that of a loved one.
Have Epinephrine and a life saving kit on hand.
Citations
- Allergy & Asthma Network. (2025, March 6). Anaphylaxis statistics. https://allergyasthmanetwork.org/anaphylaxis/anaphylaxis-statistics/
- Novembre E, et al. Fatal food anaphylaxis in adults and children. Ital J Pediatr. 2024 Mar 5;50(1):40. https://doi.org/10.1186/s13052-024-01608-x
- Rudders SA, et al. Age-related differences in the clinical presentation of food-induced anaphylaxis. J Pediatr. 2011 Feb;158(2):326-8.
- Montañez MI, et al. Epidemiology, Mechanisms, and Diagnosis of Drug-Induced Anaphylaxis. Front Immunol. 2017 May 29;8:614.
- Ahanchian H, et al. A survey of anaphylaxis etiology and treatment. Med Gas Res. 2019 Jan 9;8(4):129-134.
- WebMD. (2024, August 21). Anaphylactic shock: What you should know. https://www.webmd.com/allergies/anaphylactic-shock-facts
Written By Brooke Lounsbury
