Allergy
Allergic Reactions
Anaphylaxis
1. Stop Exposure
2. Epinephrine- Drug of Choice for Hypotension
-Stablizes Cell membranes to reverse body's response
-many dosing regimens
[Use for more Severe Reactions]
10 to 100 mcg IV bolus (may need doses exceeding 1 mg IV)
0.3 to 0.5 mg IM
1 to 4 mcg/min IV drip
[ACLS ROSC dose is 0.1 to 0.5mcg/kg/min]
3. Oxygen
[Intubate early if signs of angioedema]
4. IV fluid bolus
{May need liters}
5. Treat Bronchospasm
Albuteral: via inhaler or 2.5 to 5 mg in 3 ml NS nebolizer
6. Antihistamines
H1: diphenhydramine 25 to 50 mg slow IV (or IM)
H2: Famotidine 20 mg IV or PO or
Ranitidine 50 mg or 150 mg PO
7. Corticosteroids
(Choose one)
-Methylprednisolone 125 mg IV or 1 to 2 mg/kg IV
-Dexamethasone 10 to 20 mg IV or IM
Pediatric Dosing
Epinephrine 0.5 to 1 mcg/kg IV escalated up to 10 mcg/kg
(IM: 10 mcg/kg up to 300mcg/kg IM)
Diphenhydramine 1 mg/kg IV (max dose 50 mg)
Famotidine 0.25mg/kg IV or Ranitidine 1 mg/kg IV
Methylprednisolone 1 to 2mg/kg IV or
Dexamethasone 0.2 mg/kg IV
After Reaction Testing
1. Serum tryptase levels
peak 60 to 90 minutes after event
Repeat 18 to 24 hours after reaction
[documents was allergic reaction]
2. Refer for allergy testing and counseling
