EMS clinicians often encounter patients suffering from varying degrees of allergic reactions. It is important that they are attentive to the potential that symptoms such as shortness of breath and chest pain may be caused by exposure to a specific allergen. Severe respiratory distress and airway compromise are possible manifestations. Thus, treatment should be prompt. Antihistamines and epinephrine are the mainstays of therapy. Often, they are administered empirically, preceding the identification of the culprit allergen.