Anaphylaxis


Adult: [see Adult Anaphylaxis]

  1. Epinephrine 0.3-0.5 mg (1:1000) SQ (mild); 3-5 mg (1:10,000) IV (severe)
  2. Methylprednisolone 125-250 mg IV
  3. Diphenhydramine 25-50 mg PO/IV (mild); 50-100 mg IV (severe)
  4. Famotidine 20 mg IV/PO
  5. Ranitidine 50 mg IV
  6. Albuterol 0.5 mg NEB

Pediatric: [See Pedi Anaphylaxis]

  1. Epinephrine 1:1000 0.01 ml/kg IM/SC  (Max: 10ml/kg). May repeat x 2 over 20 min.
  2. Pedi-pen 0.15 mg IM
  3. Epinephrine Nebulized (for Stridor), use 2.25% Solution.
  4. Methyprednisolone IV/IO 2 mg/kg  OR
  5. Prednisone/Orapred PO 2 mg/kg  OR
  6. Prednisolone PO 2 mg/kg
  7. Cimetidine IV/IM/IO 5 mg/kg
  8. Ranitidine IV/IO/PO 1.5 mg/kg
  9. Diphenhydramine IV 1-2 mg/kg
*Prep for difficult airway
*IV Fluid Bolus IF HypOtensive

*If BP unresponsive to fluids, consider:
 - 0.1 mL of 1:1,000 epi in 10 mL NS over 5-10 min.
 - Then start 1-4 mcg/min drip if needed
*If HypOtensive  and on Beta-Blocker:
 -Consider glucagon 1-2 mg IV Q5 min

Observe 6 hrs for biphasic reaction
Discharge with epi-pen if stable

ZEBRA: Hereditary angioneurotic edema

 

[ Anaphylaxis (Adult) ]