Hives are a sign of a severe allergic reaction and what to do about it.

When seconds count at the pool, recognizing the first signs of trouble can be the difference between a quick save and a frightening delay. In the world of lifeguard training—like what you’ll encounter in the Jeff Ellis Management curriculum—the focus is on clarity, speed, and calm under pressure. A question you’ll often see in the knowledge checks is about allergic reactions, because the body’s response can escalate fast. So, what’s a telltale sign of a severe allergic reaction? The answer is hives.

Let me explain why hives matter—and why they’re the clue that can push a situation from worrisome to critical.

What hives really signal

Hives are raised, itchy welts that can appear anywhere on the skin. They’re not rare, but when they crop up in the context of a potential allergen exposure, they’re a flashing beacon: the body is reacting in a systemic way. It’s not just a skin issue. Hives often accompany other symptoms that point to a wider reaction—one that can affect breathing, blood pressure, and overall circulation.

But here’s the key distinction many students miss: hives themselves are a sign, not the sole story. They’re a classic indicator of a systemic response—what medical pros call anaphylaxis when it becomes severe. Anaphylaxis can involve swelling of the lips, tongue, or throat, wheezing or trouble breathing, a rapid pulse, dizziness, or fainting. The moment you notice hives alongside any of these other signs, you’re looking at a potential emergency.

Why this matters for lifeguards

At the pool, you’re not just watching for one symptom in isolation. You’re reading bodies, patterns, and the rhythm of a scene. Hives may show up in a crowded pool deck after a bite, a bee sting, or exposure to a food allergen in a concession stand. If the welts come with swelling, coughing, throat tightness, or trouble breathing, that’s a red flag. If you’re trained to spot hives and to recognize that they can signal a wider reaction, you’re ahead of the curve.

What other signs can show up, and how they relate to severity

• Skin symptoms: Hives are the classic sign, but rashes alone aren’t enough to declare emergency. When a rash is accompanied by swelling, throat tightness, or a sense of impending doom, that’s when the clock starts ticking.

• Respiratory changes: Shortness of breath, wheezing, noisy breathing, or a feeling of the chest closing in can mean the airway is at risk.

• Cardiovascular signs: Dizziness, fainting, pale or ashen skin, or a weak pulse can indicate a drop in blood pressure from a systemic reaction.

• Gastrointestinal symptoms: Nausea, vomiting, or abdominal cramps can occur, but they’re less specific. They can accompany allergies, infections, or other conditions, so they don’t alone confirm severity—but when combined with hives and breathing issues, they’re part of the bigger picture.

What to do in the moment (the practical, on-deck approach)

Think of this as your quick-start checklist. You’re not reading a textbook—you’re actively protecting lives.

• Assess and alert: If you see hives on a patron who has just had exposure to a known allergen or who is presenting other concerning signs, assume a serious reaction and call for help. If you’re at a staffed facility, alert the supervisor or call emergency medical services. Time matters.

• Check airway, breathing, circulation (the ABCs): Is the person talking normally, or is breathing labored? Are they feeling dizzy or faint? Is their skin unusually pale or sweaty? These cues guide your next steps.

• Remove the trigger when possible: If it’s safe to do so, remove the offending exposure—tent, food, insect sting source, etc. But don’t risk delaying care to remove something that’s not essential to the immediate safety.

• Administer epinephrine if prescribed and available: If the individual has an epinephrine auto-injector (EpiPen) and is known to have a severe allergy, help them use it or assist if they’re unable. This is a critical move that can buy time until EMS arrives.

• Call for advanced care and stay with the person: In a severe reaction, it’s best to stay with the patient, monitor their condition, and provide reassurance. If they’re alone, ensure someone else is contacting EMS while you focus on care.

• Position for comfort and safety: If the person is nauseated or dizzy, help them lie down with legs elevated a bit (unless that makes breathing worse). If they’re having trouble breathing, sit them up to ease airflow, but stay with them and monitor closely.

What not to do (common missteps to avoid)

• Don’t dismiss hives as nothing serious, especially if symptoms are spreading or if the person has known allergies.

• Don’t give food or drink to someone with trouble breathing or swelling of the face or tongue unless they’re fully conscious and able to swallow safely.

• Don’t wait to see if the symptoms improve on their own. Early treatment can prevent a crisis or reduce its impact.

• Don’t rely on a single symptom. Hives plus respiratory symptoms, lightheadedness, or swelling should trigger emergency care.

Connecting the dots: education that sticks

In the lifeguard world, the goal isn’t just to respond to emergencies but to prevent them by recognizing risk factors and staying vigilant. Some practical takeaways:

• Know your audience: Be aware that people around a pool may have known allergies—peanuts at a snack bar, bee stings from garden areas, or shellfish in a catered event. A quick mental map of possible triggers makes you better prepared.

• Keep lifesaving tools ready: Epinephrine auto-injectors save lives when used promptly. If you work in a facility that serves the public, know where the devices are kept, and how to access them quickly. Regular checks help prevent a moment of panic due to a device that’s not up to date.

• Communication is key: Clear, calm instructions to bystanders, visitors, and colleagues keep the scene organized. People want to help but often don’t know what to do; your guidance can direct energy toward safety.

• Practice the routine, not the memory: Familiarity with signs and steps becomes automatic through drills and realistic scenarios. You’ll notice that what feels rehearsed in a controlled setting comes across as confident and capable when a real situation arises.

A quick note on the emotional side

Allergic reactions can be alarming, and the emotional weight on the lifeguard shoulders is real. You’ll see fear in the eyes of someone who can’t catch their breath, and that fear can cascade to others on the deck. Staying calm, speaking in a reassuring tone, and sticking to a plan helps diffuse tension. It’s not just about saving a life; it’s about guiding a frightened family through a moment that’s chaotic and scary.

A little tangential thought that settles back home

If you’ve ever watched a sports coach address a tense crowd, you’ll recognize the rhythm here: acknowledge the stakes, outline the plan, and execute with confidence. The same discipline shows up in poolside emergencies. The signs may be different, but the core idea is the same: read the room, act decisively, and communicate clearly.

Why hives, specifically, deserve a shout-out

Hives are not a flashy symptom. They’re not dramatic like a thunderstorm—but they’re a reliable early indicator of a systemic reaction. For lifeguards, spotting hives can be the moment that prompts a swift escalation of care. It’s a practical cue you can train your eye on during crowded summer days, beach trips, or community events around the pool.

Putting it all together

So, the next time you’re reviewing the material that shapes the Jeff Ellis Management lifeguard framework, keep this thread in mind: hives aren’t just skin-deep. They’re a signal that something larger could be unfolding. Recognizing that signal—and knowing what to do next—keeps people safe and brings a sense of control to a chaotic moment.

If you love the blend of real-world stakes and practical steps, you’ll find that this kind of knowledge is exactly what makes lifeguard routines feel meaningful. It’s about more than responding to emergencies; it’s about building a calm, capable deck where every swimmer can enjoy the water with confidence.

Bottom line: hives matter because they’re often the first visible hint of a serious reaction. When you pair that sight with the right actions—quick assessment, emergency contact, airway monitoring, and judicious use of epinephrine if indicated—you’re doing the essential work that defines effective lifeguarding.

If you’re curious to broaden your understanding, think about how this approach applies to other wellness situations around the facility. Allergic reactions aren’t the only medical events on the spectrum; the same steady, watchful, methodical mindset helps with heat injuries, dehydration, and fainting spells. The deck rewards you for staying alert, communicating well, and acting with purpose.

In the end, the pool is a place of relaxation and fun—and also a frontline for safety. Recognizing hives as a sign of a more serious problem is a small, powerful step you can take to safeguard the people who come to swim, learn, and enjoy their time together. And that makes every shift not just a job, but a meaningful contribution to the community.