Throat/tongue/ pharyngeal/laryngeal swelling – this may cause a change in voice or upper airway sounds like stridor (high pitched inspiratory noise)

The patient may find it difficult to swallow

Shortness of breath

Tachypnoea – increased respiratory rate

Wheeze

Hypoxia

Cyanosis – very concerning sign!

Respiratory arrest

Shock: hypotension, tachycardia

Pale

Clammy

Chest pain which may have associated ECG changes of myocardial ischemia

Cardiac arrest

Confusion

Panic or anxiety

Decreased level of consciousness or loss of consciousness caused by an A, B or C problem

Skin changes often present and they may be the first symptom

Erythema – patchy or generalised red rash

Urticaria – itchy raised skin anywhere on the body, often surrounded in red flare

Angioedema- rapid swelling of area beneath skin or mucosa, generally face and throat, but can be abdomen, arms or legs

There can be gastrointestinal symptoms (e.g. vomiting, abdominal pain, incontinence)