Difference between revisions of "Allergic Reaction Anaphylactic Shock"
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Revision as of 06:20, 10 February 2018
Contents
Section 5 -MEDICAL
5.02 ALLERGIC REACTION / ANAPHYLACTIC SHOCK
INITIAL MEDICAL CARE (2.01) - Provide 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:
- ALBUTEROL (PROVENTIL) 2.5 mg via updraft. Monitor heart rate. (Consider IPRATROPIUM BROMIDE (ATROVENT) 0.5mg/2.5cc via updraft)
- If hives (urticaria) with history of systemic reaction in past: (All age ranges)
- 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:
- DIPHENHYDRAMINE (BENADRYL) oral liquid or dissolving tablet
- Refer to Handtevy System
- DIPHENHYDRAMINE (BENADRYL) oral liquid or dissolving tablet
- If mild/ moderate reaction:
- Administer FAMOTIDINE (PEPCID) 20 mg/50 ml IVPB at wide open rate
- Moderate Reaction:
- Administer FAMOTIDINE (PEPCID) 20 mg/50 ml IVPB at wide open rate
- METHYLPREDNISOLONE (SOLU-MEDROL) 125 mg slow IVP
- EPINEPHRINE 1:1,000 (1mg/ml) 0.3mg SQ
- Cardiac Arrest or Cardiopulmonary Arrest Imminent:
- 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, ALBUTEROL (PROVENTIL) 2.5 mg via updraft
- Monitor heart rate. (Consider IPRATROPIUM BROMIDE [ATROVENT])
- EPINEPHRINE 1:10,000 (0.1 mg/ml) 0.3 - 0.5 mg IVP
- If no IV, 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 EPINEPHRINE 1:10,000 (0.1 mg/ml) 0.3 mg IVP every 10 min or EPINEPHRINE 1:1,000 (1 mg/ml) - 0.3 to 0.5 mg IM every 10-15 min.
