CPG - A0704 - Anaphylaxis

Question 1

what can be given to pt’s unresponsive to adrenaline?

Answer 1

Glucagon 1-2 IU IM

Question 2

what is the preferred administration technique for IV Adreanaline?

Answer 2

syringe pump infusion

Question 3

How do you prepare an adrenaline infusion syringe pump?

Answer 3

Adrenaline 3mg added to make 50mL with 5% dextrose or NS 1ml - 60mcg

Question 4

What are the indications of anaphylaxis?

Answer 4

Sudden onset of symptoms AND

Two or more of RASH Criteria with or without antigen exposure

OR. Isolated hypotension <90 following exposure to antigen

Question 5

What are the rash criteria?

Answer 5

Respiratory distress
Abdominal symptoms
Skin/mucosal symtpms
Hypotension or altered conscious state

Question 6

what is the treatment for anaphylaxis?

Answer 6

• Monitor cardiac rhythm
• Adrenaline 500 mcg IM
• > repeat 500mcg IM @ 5 min (no max)
• > if small or frail -> 300mcg IM instead
• Provide o2
• Manage resp distress
• > Bronchospasm - Salbutamol as per asthma
• Nebulised adrenaline for upper airway obstruction

LESS THAN ADEQUATE PERFUSION

• NS 40ml/kh IV
• > consult for additional 20

DO not allow pt to stand or walk

Question 7

What is the PAED treatment for anaphylaxis?

Answer 7

monitor cardiac rhythm

• adrenaline 10mcg/kg IM
• rpt 10mcg/kg @ MINS