Anaphylaxis

Question 1

What are the features of anaphylaxis?

Answer 1

Acute/sudden onset of
- airway (throat swelling, stridor) /
breathing (wheeze, tachypnoea, cyanosis) /
circulation problems (pale, clammy. faint, low blood pressure)
- skin changes (urticaria, wheal and flare)

Question 2

How should anaphylaxis be managed?

Answer 2

ABCDE
Lie patient flat and raise legs
IM adrenaline
High flow oxygen, IV fluids challenge
Chlorphenamine
Hydrocortisone

Question 3

What are the doses of adrenaline to give according to age?

Answer 3

Children <6 years:
150 micrograms IM adrenaline (0.15mL of 1:1000 IM adrenaline)

Children 6 years - 12 years:
300 micrograms IM adrenaline (0.3mL of I1:1000 IM adrenaline)

Children over 12 and adults:
500 micrograms IM adrenaline (0.5mL of 1:1000 IM adrenaline)

Repeat after 5 mins

Question 4

What fluid challenge?

Answer 4

Adults : 500 mL

Child: 20mL/kg crystalloid

Question 5

What dose of chlorphenamine?

Answer 5

< 6 months:
250 micrograms/kg

6 months - 6 years:
2.5 mg

6-12 years:
5mg

> 12 years:
10 mg

Give IM or slow IV

Question 6

What dose of hydrocortisone?

Answer 6

< 6 months:
25 mg

6 months - 6 years:
50 mg

6-12 years:
100 mg

> 12 years:
200 mg

Give IM or slow IV