Anaphylaxis and allergic reaction

Question 1

What is severe anaphylaxis

Answer 1

(cardiovascular collapse, profound shock)

Question 2

what is moderate anaphylaxis

Answer 2

(Advancing hives, respiratory distress, etc.)

Question 3

What is mild allergic reaction

Answer 3

(Skin signs only)

Question 4

If 1:10,000 not available, you may dilute 1 mL of 1:1,000 epinephrine with…

Answer 4

9 mL of NS (1 mg/10 mL) and administer 1 mL IV or IO.

Question 5

Start IV/IO as needed. If shock syndrome is present and MAP ___ mmHg
(SBP ____), follow Shock protocol

Answer 5

< 65, < 90 mmHg

Question 6

For mild allergic reactions dose and a second option

Answer 6

Diphenhydramine 1 mg/kg IV/IO/IM/PO to a MAX of 50 mg. Consider dexamethasone 10 mg IV/IO/IM/PO.

Question 7

moderate allergic reaction, first line options and secondary

Answer 7

a. Epinephrine 1:1,000 0.3 - 0.5 mg IM. May repeat once in 5-15 minutes if needed.
b. Albuterol 2.5 mg via nebulizer.
Consider:
i. Diphenhydramine 1 mg/kg IV/IO/IM/PO to a MAX of 50 mg.
ii. Dexamethasone 10 mg IV/IO/IM/PO

Question 8

Anaphylaxis treatment

Answer 8

a. Epinephrine 1:1,000 0.3 - 0.5 mg IM. Repeat once in 5-15 minutes if patient is
still in shock Or, if IV/IO established,
b. Epinephrine 1:10,000 0.1 mg boluses IV/IO every 3-5 min titrated to effect.
MAX dose 0.5 mg.
c. If hypotensive, fluid challenge 500–1,000 mL. Repeat once if needed.
d. If time permits consider:
i. Albuterol 2.5 mg via nebulizer.
ii. Diphenhydramine 1 mg/kg IV/IO/IM/PO to a MAX of 50 mg.
iii. Dexamethasone 10 mg IV/IO/IM/PO