Respiratory

Question 1

What is the dosage for epi if you suspect anaphylaxis?

Adult protocol

Answer 1

0.3 mg (1:1000) IM repeated once after 10 minutes if no improvement

Then

0.1 mg (1:10,000) IV

Question 2

You suspect anaphylaxis in an adult patient.

What are the three things to look for before initiating treatment?

Answer 2

1) respiratory compromise - dyspnea, wheezing, stridor, hypoxemia

2) reduced BP (systolic <100 mmHg) or signs of end-organ dysfunction - hypotonia, syncope, incontinence

3) severe gastrointestinal symptoms - crampy abdominal pain, repetitive vomiting, diarrhea

Question 3

Where is the primary site for IM injections?

Answer 3

Vastus lateralis

All other options should only be used if vastus lateralis is unavailable

Question 4

Adult anaphylaxis protocol

What is the order for salbutamol?

Answer 4

400 MCG MDI q 15 minutes if moderate/severe bronchospasm to a max of 3 treatments

Question 5

Adult anaphylaxis protocol

What is the order for diphenhydramine?

Answer 5

25 mg IV repeated once in 15 minutes if required