Allergic Reaction Anaphylactic Shock
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)