Protocols

Question 1

Dx for >30kg A Anaphylaxis

Answer 1

Anaphylaxis is highly likely when any ONE of the following 3 criteria are fulfilled:
1. Acute onset of an illness (minutes to several hours) with involvement of the skin, mucosal tissue, or both (eg, generalized
hives, pruritus or flushing, swollen lips-tongue-uvula)
AND AT LEAST ONE OF THE FOLLOWING
A. Respiratory compromise (e.g., dyspnea, wheeze-bronchospasm, stridor, SPO2 < 92%)
B. Reduced BP or absent radial pulse or decreased level of consciousness

2. TWO OR MORE OF THE FOLLOWING that occur rapidly after exposure to a likely allergen for that patient (minutes to
   several hours):
   A. Involvement of the skin-mucosal tissue (e.g., generalized hives, itch-flush, swollen lips-tongue-uvula)
   B. Respiratory compromise (e.g., dyspnea, wheeze-bronchospasm, stridor, SPO2 < 92%)
   C. Reduced BP or absent radial pulse or decreased level of consciousness
   D. Persistent gastrointestinal symptoms (e.g., crampy abdominal pain, vomiting)
3. Reduced BP after exposure to a known allergen for that patient (minutes to several hours):
   A. Infants and children: low systolic BP (age specific)* or greater than 30 percent decrease in systolic BP
   B. Adults: systolic BP of less than 90 mm Hg or greater than 30 percent decrease from that person’s baseline

Question 2

Red Flags TBI

Answer 2

1. Any Loss of consciousness
2. Severe/worsening headache
3. GCS < 15
4. Seizure(s) with current event
5. Repeated vomiting
6. Declining neurologic status
7. Symptoms/signs of basilar skull fracture:
   hemotympanum, raccoon eyes, Battle’s sign, rhinorrhea, otorrhea
8. Pupil asymmetry
9. Abnormal speech
10. Double vision
11. Weakness/numbness in arms, legs or face
12. Any post-traumatic amnesia
13. Unusual behavior

Question 3

Dx <30kg Anaphylaxis

Answer 3

Anaphylaxis is highly likely when any ONE of the following 3 criteria are fulfilled:
1. Acute onset of an illness (minutes to several hours) with involvement of the skin, mucosal tissue, or both (eg, generalized
hives, pruritus or flushing, swollen lips-tongue-uvula)
AND AT LEAST ONE OF THE FOLLOWING
A. Respiratory compromise (e.g., dyspnea, wheeze-bronchospasm, stridor, SPO2 < 92%)
B. Reduced BP* or absent radial pulse or decreased level of consciousness
2. TWO OR MORE OF THE FOLLOWING that occur rapidly after exposure to a likely allergen for that patient (minutes to
several hours):
A. Involvement of the skin-mucosal tissue (e.g., generalized hives, itch-flush, swollen lips-tongue-uvula)
B. Respiratory compromise (e.g., dyspnea, wheeze-bronchospasm, stridor, SPO2 < 92%)
C. Reduced BP* or absent radial pulse or decreased level of consciousness
D. Persistent gastrointestinal symptoms (e.g., crampy abdominal pain, vomiting)

3. Reduced BP* after exposure to a known allergen for that patient (minutes to several hours):
   A. Infants and children: low systolic BP (age specific)* or greater than 30 percent decrease in systolic BP
   B. Adults: systolic BP of less than 90 mm Hg or greater than 30 percent decrease from that person’s baseline