Allergic Reaction Anaphylactic Shock - Revision history

Mfrdmanager at 13:46, 13 November 2020

2020-11-13T13:46:35Z

Mfrdmanager at 12:41, 17 September 2019

2019-09-17T12:41:31Z

Mfrdmanager at 11:49, 17 September 2019

2019-09-17T11:49:49Z

Mfrdmanager: Protected "Allergic Reaction Anaphylactic Shock" ([Edit=Allow only administrators] (indefinite) [Move=Allow only administrators] (indefinite))

2018-02-10T14:20:41Z

Protected "Allergic Reaction Anaphylactic Shock" ([Edit=Allow only administrators] (indefinite) [Move=Allow only administrators] (indefinite))

Mfrdmanager: Created page with "==Section 5 -MEDICAL== ===5.02 ALLERGIC REACTION / ANAPHYLACTIC SHOCK=== INITIAL MEDICAL CARE (2.01) - Provide [[Medical Gases|OXYGEN]..."

2018-02-10T14:20:34Z

Created page with "==Section 5 -MEDICAL== ===5.02 ALLERGIC REACTION / ANAPHYLACTIC SHOCK=== INITIAL MEDICAL CARE (2.01) - Provide [[Medical Gases|OXYGEN]..."

New page

==Section 5 -MEDICAL==
===5.02 ALLERGIC REACTION / ANAPHYLACTIC SHOCK===

[[Initial Medical Assessment and Care|INITIAL MEDICAL CARE]] (2.01) - Provide [[Medical Gases|OXYGEN]] or assist ventilations as appropriate for patient condition.
* Establish IV or administer medications into extremity without bite or injection of allergen.
* Administer medications into areas without hives (urticaria)

==== ALLERGIC REACTION: For pediatric patients, refer to Handtevy System for dosing====
* If wheezing present:
**[[Bronchodilators|ALBUTEROL (PROVENTIL)]] 2.5 mg via updraft. Monitor heart rate. (Consider [[Bronchodilators|IPRATROPIUM BROMIDE (ATROVENT)]] 0.5mg/2.5cc via updraft)
* If hives (urticaria) with history of systemic reaction in past: (All age ranges)
**[[Antihistamines|DIPHENHYDRAMINE (BENADRYL)]] 1 mg / kg IVP not to exceed 50 mg slowly over 2 -3 minutes. If no IV access, may give IM
* For pediatric patients presenting with a mild or localized allergic skin reaction (urticaria) with no respiratory involvement:
**[[Antihistamines|DIPHENHYDRAMINE (BENADRYL)]] oral liquid or dissolving tablet
***Refer to Handtevy System
* If mild/ moderate reaction:
**Administer [[Antihistamines|FAMOTIDINE (PEPCID)]] 20 mg/50 ml IVPB at wide open rate
* Moderate Reaction:
**Administer [[Antihistamines|FAMOTIDINE (PEPCID)]] 20 mg/50 ml IVPB at wide open rate
**[[Corticosteroids|METHYLPREDNISOLONE (SOLU-MEDROL)]] 125 mg slow IVP
**[[Adrenergics|EPINEPHRINE]] 1:1,000 (1mg/ml) 0.3mg SQ
* Cardiac Arrest or Cardiopulmonary Arrest Imminent:
**[[Adrenergics|EPINEPHRINE]] 1:10,000 (0.1mg/ml) 0.3mg IVP (instead of 1:1,000)
**Consider all appropriate therapeutic and/or pharmacologic modalities to correct the condition.

====ANAPHYLACTIC SHOCK: For pediatric patients, refer to Handtevy System for dosing====
* If wheezing present, [[Bronchodilators|ALBUTEROL (PROVENTIL)]] 2.5 mg via updraft
**Monitor heart rate. (Consider [[Bronchodilators|IPRATROPIUM BROMIDE [ATROVENT]]])
* [[Adrenergics|EPINEPHRINE]] 1:10,000 (0.1 mg/ml) 0.3 - 0.5 mg IVP
**If no IV, [[Adrenergics|EPINEPHRINE]] 1:1,000 (1 mg/ml) 0.3 - 0.5 mg IM
* Fluid boluses in increments of 200 - 300 ml, to titrate systolic BP > 90 mm Hg
* May repeat [[Adrenergics|EPINEPHRINE]] 1:10,000 (0.1 mg/ml) 0.3 mg IVP every 10 min or [[Adrenergics|EPINEPHRINE]] 1:1,000 (1 mg/ml) - 0.3 to 0.5 mg IM every 10-15 min.

[[Category:Medical|0502]]

@@ Line 7: / Line 7: @@
 ===[[Initial Medical Assessment and Care|INITIAL MEDICAL CARE]] (2.01)===
-* Provide [[Medical Gases|OXYGEN]] or assist ventilations as appropriate for patient condition.
+* Provide [[Oxygen|OXYGEN]] or assist ventilations as appropriate for patient condition.
 * Establish IV or administer medications into extremity without bite or injection of allergen.
 * Administer medications into areas without hives (urticaria)
 === <span style="color: green;">MILD (urticaria, no respiratory involvement)</span> ===
-*[[Antihistamines|DIPHENHYDRAMINE (BENADRYL)]] 25-50mg IM/IVP
+*[[Diphenhydramine|DIPHENHYDRAMINE (BENADRYL)]] 25-50mg IM/IVP
-*Consider [[Corticosteroids|METHYLPREDNISOLONE (SOLU-MEDROL)]] 125mg IM/IVP if the speed of reaction appears rapid.
+*Consider [[Solu-Medrol|METHYLPREDNISOLONE (SOLU-MEDROL)]] 125mg IM/IVP if the speed of reaction appears rapid.
 === <span style="color: gold;">MODERATE (mild respiratory involvement)</span> ===
-*[[Antihistamines|DIPHENHYDRAMINE (BENADRYL)]] 25-50mg IM/IVP
+*[[Diphenhydramine|DIPHENHYDRAMINE (BENADRYL)]] 25-50mg IM/IVP
-*[[Corticosteroids|METHYLPREDNISOLONE (SOLU-MEDROL)]] 125mg IVP/IM
+*[[Solu-Medrol|METHYLPREDNISOLONE (SOLU-MEDROL)]] 125mg IVP/IM
-*[[Antihistamines|FAMOTIDINE (PEPCID)]] 20mg/50ml IVPB
+*[[Pepcid|FAMOTIDINE (PEPCID)]] 20mg/50ml IVPB
-*[[Adrenergics|EPINEPHRINE]] UPDRAFT (1mg/1ml (1:1000) + 2ml NS)
+*[[Epinephrine|EPINEPHRINE]] UPDRAFT (1mg/1ml + 2ml NS)
-*[[Bronchodilators|ALBUTEROL (PROVENTIL)]] 2.5mg via updraft
+*[[Albuterol|ALBUTEROL (PROVENTIL)]] 2.5mg via updraft
 		+/-
 *IPRATROPIUM (ATROVENT) 0.5mg via updraft
@@ Line 28: / Line 28: @@
 === <span style="color: red;">SEVERE (stridor / airway involvement) </span> ===
-*[[Adrenergics|EPINEPHRINE]] 1mg/1ml   0.3-0.5mg IM (may repeat q 10min)
+*[[Epinephrine|EPINEPHRINE]] 1mg/1ml   0.3-0.5mg IM (may repeat q 10min)
-*[[Antihistamines|DIPHENHYDRAMINE (BENADRYL)]] 50mg IM/IVP
+*[[Diphenhydramine|DIPHENHYDRAMINE (BENADRYL)]] 50mg IM/IVP
-*[[Corticosteroids|METHYLPREDNISOLONE (SOLU-MEDROL)]] 125mg IM/IVP
+*[[Solu-Medrol|METHYLPREDNISOLONE (SOLU-MEDROL)]] 125mg IM/IVP
-*[[Antihistamines|FAMOTIDINE (PEPCID)]] 20mg/50ml IVPB
+*[[Pepcid|FAMOTIDINE (PEPCID)]] 20mg/50ml IVPB
 *IV NS BOLUS 500-1000ml (maintain systolic BP > 90mm HG)
-*[[Bronchodilators|ALBUTEROL (PROVENTIL)]] 2.5mg via updraft
+*[[Albuterol|ALBUTEROL (PROVENTIL)]] 2.5mg via updraft
 		+/-
-*[[Bronchodilators|IPRATROPIUM BROMIDE [ATROVENT]]] 0.5mg via updraft
+*[[Atrovent|IPRATROPIUM BROMIDE [ATROVENT]]] 0.5mg via updraft
 === <span style="color: red;">ANAPHYLACTIC SHOCK / CARDIAC ARREST IMMINENT</span> ===
-*[[Adrenergics|EPINEPHRINE]] 0.1mg/1ml   0.5-1mg IVP (may repeat q 10 min)
+*[[Epinephrine|EPINEPHRINE]] 0.1mg/1ml   0.5-1mg IVP (may repeat q 10 min)
 *IV NS BOLUS 500-1000ml (maintain systolic BP > 90mm HG)
 [[Category:Medical|0502]]

@@ Line 20: / Line 20: @@
 *[[Corticosteroids|METHYLPREDNISOLONE (SOLU-MEDROL)]] 125mg IVP/IM
 *[[Antihistamines|FAMOTIDINE (PEPCID)]] 20mg/50ml IVPB
-*[[Adrenergics|EPINEPHRINE]] UPDRAFT (1mg/1ml + 2ml NS)
+*[[Adrenergics|EPINEPHRINE]] UPDRAFT (1mg/1ml (1:1000) + 2ml NS)
 *[[Bronchodilators|ALBUTEROL (PROVENTIL)]] 2.5mg via updraft

@@ Line 2: / Line 2: @@
 ===5.02 ALLERGIC REACTION / ANAPHYLACTIC SHOCK===
-[[Initial Medical Assessment and Care|INITIAL MEDICAL CARE]] (2.01) - Provide [[Medical Gases|OXYGEN]] or assist ventilations as appropriate for patient condition.
+*For pediatric patients, refer to Handtevy
 * Establish IV or administer medications into extremity without bite or injection of allergen.
 * Administer medications into areas without hives (urticaria)
-==== ALLERGIC REACTION: For pediatric patients, refer to Handtevy System for dosing====
+=== <span style="color: green;">MILD (urticaria, no respiratory involvement)</span> ===
-* If wheezing present:
+*[[Antihistamines|DIPHENHYDRAMINE (BENADRYL)]] 25-50mg IM/IVP
-**[[Bronchodilators|ALBUTEROL (PROVENTIL)]] 2.5 mg via updraft. Monitor heart rate. (Consider [[Bronchodilators|IPRATROPIUM BROMIDE (ATROVENT)]] 0.5mg/2.5cc via updraft)
+*Consider [[Corticosteroids|METHYLPREDNISOLONE (SOLU-MEDROL)]] 125mg IM/IVP if the speed of reaction appears rapid.
-* If hives (urticaria) with history of systemic reaction in past: (All age ranges)
-**[[Antihistamines|DIPHENHYDRAMINE (BENADRYL)]] 1 mg / kg IVP not to exceed 50 mg slowly over 2 -3 minutes. If no IV access, may give IM
-* For pediatric patients presenting with a mild or localized allergic skin reaction (urticaria) with no respiratory involvement:
+=== <span style="color: gold;">MODERATE (mild respiratory involvement)</span> ===
-**[[Antihistamines|DIPHENHYDRAMINE (BENADRYL)]] oral liquid or dissolving tablet
+*[[Antihistamines|DIPHENHYDRAMINE (BENADRYL)]] 25-50mg IM/IVP
-***Refer to Handtevy System
+*[[Corticosteroids|METHYLPREDNISOLONE (SOLU-MEDROL)]] 125mg IVP/IM
-* If mild/ moderate reaction:
+*[[Antihistamines|FAMOTIDINE (PEPCID)]] 20mg/50ml IVPB
-**Administer [[Antihistamines|FAMOTIDINE (PEPCID)]] 20 mg/50 ml IVPB at wide open rate
+*[[Adrenergics|EPINEPHRINE]] UPDRAFT (1mg/1ml + 2ml NS)
-* Moderate Reaction:
-**Administer [[Antihistamines|FAMOTIDINE (PEPCID)]] 20 mg/50 ml IVPB at wide open rate
+*[[Bronchodilators|ALBUTEROL (PROVENTIL)]] 2.5mg via updraft
-**[[Corticosteroids|METHYLPREDNISOLONE (SOLU-MEDROL)]] 125 mg slow IVP
+		+/-
-**[[Adrenergics|EPINEPHRINE]] 1:1,000 (1mg/ml) 0.3mg SQ
+*IPRATROPIUM (ATROVENT) 0.5mg via updraft
-* Cardiac Arrest or Cardiopulmonary Arrest Imminent:
-**[[Adrenergics|EPINEPHRINE]] 1:10,000 (0.1mg/ml) 0.3mg IVP (instead of 1:1,000)
-**Consider all appropriate therapeutic and/or pharmacologic modalities to correct the condition.
+=== <span style="color: red;">SEVERE (stridor / airway involvement) </span> ===
-====ANAPHYLACTIC SHOCK: For pediatric patients, refer to Handtevy System for dosing====
+=== <span style="color: red;">ANAPHYLACTIC SHOCK / CARDIAC ARREST IMMINENT</span> ===
-* If wheezing present, [[Bronchodilators|ALBUTEROL (PROVENTIL)]] 2.5 mg via updraft
+*[[Adrenergics|EPINEPHRINE]] 0.1mg/1ml   0.5-1mg IVP (may repeat q 10 min)
-**Monitor heart rate. (Consider [[Bronchodilators|IPRATROPIUM BROMIDE [ATROVENT]]])
+*IV NS BOLUS 500-1000ml (maintain systolic BP > 90mm HG)
 [[Category:Medical|0502]]

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