Anaphylaxis

Question 1

Anaphylaxis Assessment

Answer 1

• Assess A,B,C
• Treat life-threatening problems immediately
• 100% O2 and assist ventilation or intubate
• IV access
• Determine Hx r/t allergy

Question 2

Anaphylaxis Tx

Answer 2

Mild wheezing and/or Urticarial Rash, Hemodynamically stable:
-Albuterol
-Consider Diphenhydramine 1-2 mg/kg/dose skow IVP (Max 50 mg)
Moderate to Severe wheezing/stridor, tachycardia, decreased perfusion, hypotension:
-Epinephrine (1:1000) 0.01 mL/kg/dose IM (max single dose 0.5 mg), may repeat after 15 min. (*Max total dose 1mg)
-Fluid Bolus NS/LR 20 mL/kg
-Albuterol or Racemic Epi HHN if wheezing or stridor present

Question 3

If symptoms worsen?

Answer 3

-Repeat Epinephrine
-Ranitidine (Zantac) 1 mg/kg IV (Max dose 150 mg)
Consider for latent phase:
-Dexamethasone 0.4-0.6 mg/kg IV, *OR Solu-Medrol 2mg/kg IV, *OR Hydrocortisone 1-2 mg/kg IV

Question 4

For severe reactions:

Answer 4

• Contact Medical Control
• for severe reactions with uncompensated shock (hypoTN) resistant to previous measures, may have to use Epinephrine (1:10,000) 0.1 ml/kg IV (Max single dose: 0.5mg, Max total dose: 1mg)