24/7 Emergency Room in Irving, TX
A severe allergic reaction can close the airway in minutes. Use your epinephrine first, call 911 second, and let us watch for the second wave. Open 24/7.
Anaphylaxis is a severe allergic reaction that hits two or more body systems at once. The immune system floods the body with histamine, blood vessels leak, airways swell, and blood pressure drops. Without fast treatment it can close the airway entirely.
Emergency visits for anaphylaxis have more than doubled since 2008, with an estimated 45,000 to 50,000 per year in the United States. Food, medications, and insect stings are the three biggest triggers, and Texas fire ants earn their place on that list.
The treatment order matters: epinephrine first, 911 second, and monitored observation after, because this reaction has a habit of coming back.
Medically reviewed by the ER of Irving Medical Team | Updated: July 2026
The rule: two or more body systems reacting together is anaphylaxis. The first two mean inject epinephrine and call 911 immediately.
A tight throat, hoarse voice, or swelling lips and tongue. Use epinephrine and call 911.
Widespread hives with wheezing, vomiting, or dizziness is two systems reacting. Call 911.
Airways narrowing after an exposure, with coughing or chest tightness.
Blood pressure dropping fast, often with cold sweaty skin and a racing pulse.
Sudden nausea, cramping, or diarrhea within an hour of a trigger.
Intense whole-body itch and red, hot skin arriving within minutes of exposure.
A sudden overwhelming feeling that something is deeply wrong. Believe it.
A second wave can return 1 to 8 hours after the first settles, even after an EpiPen.
Anaphylaxis care moves in minutes, with epinephrine stocked at the bedside.
Intramuscular epinephrine immediately, repeated every 5 to 15 minutes if symptoms persist.
Positioning, oxygen, and full airway readiness if swelling threatens breathing.
Fluid boluses for low blood pressure, plus antihistamines, steroids and bronchodilators.
Several hours of monitoring to catch a biphasic second wave before it turns dangerous.
Epinephrine reverses the reaction, but it wears off within 10 to 20 minutes, and up to 1 in 5 anaphylaxis cases involves a biphasic reaction: a second wave that returns 1 to 8 hours later, even when the first dose seemed to fix everything.
That is what the observation window is for. You stay monitored with IV access and additional epinephrine ready, and you leave with what prevents the next crisis: two auto-injector prescriptions, a written action plan, and an allergist referral for trigger testing.
Hives without other symptoms may just be a skin reaction, covered on our rash treatment page. Wheezing that lingers afterward runs through our breathing care. Anaphylaxis is when those worlds collide.
When in doubt, use the epinephrine. It causes little harm in a milder reaction. Withholding it in true anaphylaxis can be fatal.
Trouble breathing or swallowing, lip or tongue swelling, hives with dizziness or vomiting, or fainting. Inject first, call second, lie down and wait.
Even if you feel completely fine. Up to 1 in 5 reactions returns within 8 hours, and the rebound is the one nobody sees coming.
A few local hives with normal breathing can be watched with an antihistamine. The moment a second body system joins in, use the EpiPen.
Yes. Up to 1 in 5 anaphylaxis cases has a biphasic reaction, a second wave that returns 1 to 8 hours later even when the first dose seemed to fix everything. Monitored observation catches the rebound before it becomes airway swelling.
Epinephrine wears off within 10 to 20 minutes. The reaction can outlast the medicine, which is why a second dose is often needed and why the observation period after an injection is not optional.
Usually the immune system needs a prior meeting with the trigger, but that first exposure can be so mild it went unnoticed, especially with insect stings and medications. Treat any first severe reaction exactly like a known allergy.
Yes, in an emergency. An expired auto-injector still delivers most of its epinephrine, and some is far better than none. Use it, call 911, and replace the device after the event.
Prevention becomes the goal: an allergist confirms your triggers with testing, you carry two epinephrine auto-injectors everywhere, and you leave with a written action plan for family, school, or work. Severe insect-venom allergies may qualify for immunotherapy that dramatically cuts future risk.
Emergency care is protected. Under the federal No Surprises Act and Texas Department of Insurance balance-billing rules, patients are shielded from surprise balance bills for emergency treatment. We post all required Texas disclosures and can discuss costs with you on arrival.
Stocked epinephrine, monitored observation, and a plan that prevents the next reaction. Open 24 hours a day, every day.
