Early Adrenaline Use Remains Key in Child Anaphylaxis, Study Says 

New research from the University of Bristol and Bristol Royal Hospital for Children has highlighted critical delays in the use of adrenaline auto-injectors (AAIs) in children experiencing fatal food-induced anaphylaxis, prompting calls for urgent improvements in awareness, preparedness and guidance.  

The findings¹, presented on 28 April 2026 at the Royal College of Emergency Medicine Conference, analysed cases from the National Child Mortality Database to understand what happens in fatal reactions and how future deaths could be prevented.  

A very short window to act 

Anaphylaxis is a severe, life-threatening allergic reaction that can develop rapidly. The research emphasises just how quickly these emergencies can escalate. 

Despite this, in 74% of cases children received either no adrenaline at all or only a single dose before cardiac arrest. This reinforces the vital message that adrenaline should be given promptly at the first signs of a serious allergic reaction, and that more than one dose may be needed.  

Gaps in carrying and using AAIs 

The research also identified concerning gaps in preparedness. More than a third (37%) of the children included in the study were not carrying an adrenaline auto-injector at the time of their reaction. In several cases, no injector was available at all, or only one device was on hand — preventing a second dose from being administered quickly if symptoms did not improve.  

These findings highlight the importance of: 

• Always carrying prescribed AAIs 
• Ensuring two AAIs are available at all times
• Making sure family, carers, schools and friends know where they are and how to use them  

Most deaths occur before hospital 

All of the children in the study went into cardiac arrest before reaching hospital care. This underlines the critical role of immediate, effective action in the community, whether at home, at school or in public places. Prompt recognition of symptoms and rapid administration of adrenaline can be lifesaving.  

Breathing problems are a key risk 

The research also provides important insights into how fatal reactions develop. In nearly all cases where a cause could be identified, problems with breathing (airway and lung function) were the main reason for death.  

This finding suggests that anaphylaxis caused by food is often driven by airway narrowing and difficulty breathing, rather than primarily by heart or circulatory collapse.  

Experts are calling for this evidence to be reflected in clinical guidance to ensure the most effective emergency care is prioritised. 

What this means for people living with serious allergies 

Although fatal food anaphylaxis is rare, it is often preventable. This research reinforces key safety messages for anyone at risk of serious allergic reactions: 

1. Carry your AAIs at all times,
2. Carry two devices, in case a second dose is needed,
3. Use adrenaline immediately at the first signs of a serious reaction,
4. Call emergency services after using an AAI,
5. Ensure those around you know how to recognise anaphylaxis and use an AAI.

For children and teenagers who made up most of the cases studied, it is especially important that schools, parents and peers are confident in recognising and responding to anaphylaxis quickly. 

Support from Anaphylaxis UK 

At Anaphylaxis UK, we continue to support individuals, families, schools and healthcare professionals with trusted guidance, training and resources. If you or someone you care for is at risk of serious allergic reactions, you can find practical advice on: 

• Recognising the symptoms of anaphylaxis 

• How and when to use an adrenaline auto-injector. Learn in more in our What to do in an emergency Guide

1. Fatal delays in EpiPen treatment for food anaphylaxis in children, finds research ↩︎