Anaphylaxis

Question 1

Dose and mode of delivery of adrenaline for children and adults

Answer 1

IM Epinepherine (Adrenaline)

Children: 0.01mg/kg IM STAT (max 0.3mg)

Adults: 0.3-0.5mg IM STAT

Repeat every 10-15 minutes if needed

Question 2

Aside from adrenaline treatment, other key aspects of acute anaphylaxis management

Answer 2

Airway management - intubate prophylactically if pronounced stridor before things clamp down (otherwise may be forced to do cricothorectomy). Give O2

Inhaved beta 2 agonists may be useful if prolonged respiratory symptoms after emergency passed

If Hypotensive - saline fluid replacement to maintain cardiovascular stability

Adults: Infuse at rate of 5-10ml/kg over first 5 mins, usually aim for 1-2 L within first hour

Children: 30ml/kg over first hour

Question 3

Ongoing therapy after acute anaphylaxis managed?

Answer 3

Children: Methylprednisolone 1-2mg/kg/day IV

Adults: Prednisolone 0.5-1mg/kg/day orally

May require ongoing antihistamine therapy