Allergic Reaction Anaphylactic Shock: Difference between revisions
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===[[Initial Medical Assessment and Care|INITIAL MEDICAL CARE]] (2.01)=== | ===[[Initial Medical Assessment and Care|INITIAL MEDICAL CARE]] (2.01)=== | ||
* Provide [[ | * Provide [[Oxygen|OXYGEN]] or assist ventilations as appropriate for patient condition. | ||
* Establish IV or administer medications into extremity without bite or injection of allergen. | * Establish IV or administer medications into extremity without bite or injection of allergen. | ||
* Administer medications into areas without hives (urticaria) | * Administer medications into areas without hives (urticaria) | ||
| Line 13: | Line 13: | ||
=== <span style="color: green;">MILD (urticaria, no respiratory involvement)</span> === | === <span style="color: green;">MILD (urticaria, no respiratory involvement)</span> === | ||
*[[Diphenhydramine|DIPHENHYDRAMINE (BENADRYL)]] 25-50mg IM/IVP | *[[Diphenhydramine|DIPHENHYDRAMINE (BENADRYL)]] 25-50mg IM/IVP | ||
*Consider [[ | *Consider [[Solu-Medrol|METHYLPREDNISOLONE (SOLU-MEDROL)]] 125mg IM/IVP if the speed of reaction appears rapid. | ||
=== <span style="color: gold;">MODERATE (mild respiratory involvement)</span> === | === <span style="color: gold;">MODERATE (mild respiratory involvement)</span> === | ||
*[[Diphenhydramine|DIPHENHYDRAMINE (BENADRYL)]] 25-50mg IM/IVP | *[[Diphenhydramine|DIPHENHYDRAMINE (BENADRYL)]] 25-50mg IM/IVP | ||
*[[ | *[[Solu-Medrol|METHYLPREDNISOLONE (SOLU-MEDROL)]] 125mg IVP/IM | ||
*[[Pepcid|FAMOTIDINE (PEPCID)]] 20mg/50ml IVPB | *[[Pepcid|FAMOTIDINE (PEPCID)]] 20mg/50ml IVPB | ||
*[[Epinephrine|EPINEPHRINE]] UPDRAFT (1mg/1ml + 2ml NS) | *[[Epinephrine|EPINEPHRINE]] UPDRAFT (1mg/1ml + 2ml NS) | ||
*[[ | *[[Albuterol|ALBUTEROL (PROVENTIL)]] 2.5mg via updraft | ||
+/- | +/- | ||
*IPRATROPIUM (ATROVENT) 0.5mg via updraft | *IPRATROPIUM (ATROVENT) 0.5mg via updraft | ||
| Line 30: | Line 30: | ||
*[[Epinephrine|EPINEPHRINE]] 1mg/1ml 0.3-0.5mg IM (may repeat q 10min) | *[[Epinephrine|EPINEPHRINE]] 1mg/1ml 0.3-0.5mg IM (may repeat q 10min) | ||
*[[Diphenhydramine|DIPHENHYDRAMINE (BENADRYL)]] 50mg IM/IVP | *[[Diphenhydramine|DIPHENHYDRAMINE (BENADRYL)]] 50mg IM/IVP | ||
*[[ | *[[Solu-Medrol|METHYLPREDNISOLONE (SOLU-MEDROL)]] 125mg IM/IVP | ||
*[[Pepcid|FAMOTIDINE (PEPCID)]] 20mg/50ml IVPB | *[[Pepcid|FAMOTIDINE (PEPCID)]] 20mg/50ml IVPB | ||
*IV NS BOLUS 500-1000ml (maintain systolic BP > 90mm HG) | *IV NS BOLUS 500-1000ml (maintain systolic BP > 90mm HG) | ||
*[[ | *[[Albuterol|ALBUTEROL (PROVENTIL)]] 2.5mg via updraft | ||
+/- | +/- | ||
*[[ | *[[Atrovent|IPRATROPIUM BROMIDE [ATROVENT]]] 0.5mg via updraft | ||
=== <span style="color: red;">ANAPHYLACTIC SHOCK / CARDIAC ARREST IMMINENT</span> === | === <span style="color: red;">ANAPHYLACTIC SHOCK / CARDIAC ARREST IMMINENT</span> === | ||
Latest revision as of 14:29, 24 April 2020
Section 5 -MEDICAL
5.02 ALLERGIC REACTION / ANAPHYLACTIC SHOCK
- For pediatric patients, refer to Handtevy
- Reactions tend to be more severe if they occur immediately after contact or ingestion
- Exam airway for edema
INITIAL MEDICAL CARE (2.01)
- Provide OXYGEN or assist ventilations as appropriate for patient condition.
- Establish IV or administer medications into extremity without bite or injection of allergen.
- Administer medications into areas without hives (urticaria)
MILD (urticaria, no respiratory involvement)
- DIPHENHYDRAMINE (BENADRYL) 25-50mg IM/IVP
- Consider METHYLPREDNISOLONE (SOLU-MEDROL) 125mg IM/IVP if the speed of reaction appears rapid.
MODERATE (mild respiratory involvement)
- DIPHENHYDRAMINE (BENADRYL) 25-50mg IM/IVP
- METHYLPREDNISOLONE (SOLU-MEDROL) 125mg IVP/IM
- FAMOTIDINE (PEPCID) 20mg/50ml IVPB
- EPINEPHRINE UPDRAFT (1mg/1ml + 2ml NS)
- ALBUTEROL (PROVENTIL) 2.5mg via updraft
+/-
- IPRATROPIUM (ATROVENT) 0.5mg via updraft
SEVERE (stridor / airway involvement)
- EPINEPHRINE 1mg/1ml 0.3-0.5mg IM (may repeat q 10min)
- DIPHENHYDRAMINE (BENADRYL) 50mg IM/IVP
- METHYLPREDNISOLONE (SOLU-MEDROL) 125mg IM/IVP
- FAMOTIDINE (PEPCID) 20mg/50ml IVPB
- IV NS BOLUS 500-1000ml (maintain systolic BP > 90mm HG)
- ALBUTEROL (PROVENTIL) 2.5mg via updraft
+/-
- IPRATROPIUM BROMIDE [ATROVENT] 0.5mg via updraft
ANAPHYLACTIC SHOCK / CARDIAC ARREST IMMINENT
- EPINEPHRINE 0.1mg/1ml 0.5-1mg IVP (may repeat q 10 min)
- IV NS BOLUS 500-1000ml (maintain systolic BP > 90mm HG)