Anaphylaxis and allergic reaction

Question 1

Severe allergic reaction treatment, how often can we repeat treatment

Answer 1

Epinephrine 1:1,000 0.3 - 0.5 mg IM. Repeat once in 5-15 minutes if patient is
still in shock

Question 2

Severe allergic reactions. What do we do if there is extra time; three treatments

Answer 2

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

Question 3

PEDS mild reaction

Answer 3

a. Diphenhydramine 1 mg/kg IV/IO/IM/PO to a MAX of 50 mg.
b. Consider dexamethasone 0.6 mg/kg IV/IO/IM/PO to a MAX of 10 mg.

Question 4

PEDS Moderate Reaction (Respiratory Signs)

Answer 4

a. Epinephrine 1:1,000. Administer 0.01 mg/kg IM to a MAX of 0.5 mg.
May repeat once in 5-15 minutes if needed.
b. Albuterol 2.5 mg via nebulizer.
c. Consider:
i. Diphenhydramine 1 mg/kg IV/IO/IM/PO to a MAX of 50 mg.
ii. Dexamethasone 0.6 mg/kg IV/IO/IM/PO to a MAX of 10 mg

Question 5

PEDS Severe Reaction Shock (BP < for Age

Answer 5

a. Epinephrine 1:1,000. Administer 0.01 mg/kg IM to a MAX of 0.5 mg.
Repeat once in 5-15 minutes if patient is still in severe shock

Question 6

Lowest normal pediatric systolic BP by age

Answer 6

a. Less than one month: > 60 mmHg.
b. One month to 1 year: > 70 mmHg.
c. Greater than 1 year: 70 + 2 x age in years.

Question 7

Common side effects of EPI include___

Answer 7

anxiety, tremor, palpations, tachycardia, and headache.

Question 8

Anaphylaxis in a patient on beta-blockers may present with____

Answer 8

severe bronchospasm, profound hypotension and bradycardia