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 [[Medical Gases|OXYGEN]] or assist ventilations as appropriate for patient condition.
* 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)


=== <span style="color: green;">MILD (urticaria, no respiratory involvement)</span> ===
=== <span style="color: green;">MILD (urticaria, no respiratory involvement)</span> ===
*DIPHENHYRADMINE (BENADRYL) 25-50mg IM/IVP
*[[Diphenhydramine|DIPHENHYDRAMINE (BENADRYL)]] 25-50mg IM/IVP
*Consider METHYLPREDNISOLONE (SOLU-MEDROL) 125mg IM/IVP if the speed of reaction appears rapid.  
*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> ===
*DIPHENHYRADMINE (BENADRYL) 25-50mg IM/IVP  
*[[Diphenhydramine|DIPHENHYDRAMINE (BENADRYL)]] 25-50mg IM/IVP  
*METHYLPREDNISOLONE (SOLU-MEDROL) 125mg IVP/IM
*[[Solu-Medrol|METHYLPREDNISOLONE (SOLU-MEDROL)]] 125mg IVP/IM
*FAMOTIDINE (PEPCID) 20mg/50ml IVPB  
*[[Pepcid|FAMOTIDINE (PEPCID)]] 20mg/50ml IVPB  
*EPINEPHRINE UPDRAFT (1:1,000 + 2ml NS)
*[[Epinephrine|EPINEPHRINE]] UPDRAFT (1mg/1ml + 2ml NS)


*ALBUTEROL (PROVENTIL) 2.5mg via updraft
*[[Albuterol|ALBUTEROL (PROVENTIL)]] 2.5mg via updraft
+/-  
+/-  
*IPRATROPIUM (ATROVENT) 0.5mg via updraft
*IPRATROPIUM (ATROVENT) 0.5mg via updraft
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=== <span style="color: red;">SEVERE (stridor / airway involvement) </span> ===
=== <span style="color: red;">SEVERE (stridor / airway involvement) </span> ===
*EPINEPHRINE 1:1,000   0.3-0.5mg IM (may repeat q 10min)
*[[Epinephrine|EPINEPHRINE]] 1mg/1ml   0.3-0.5mg IM (may repeat q 10min)
*DIPHENHYRADMINE (BENADRYL) 50mg IM/IVP
*[[Diphenhydramine|DIPHENHYDRAMINE (BENADRYL)]] 50mg IM/IVP
*METHYLPREDNISOLONE (SOLU-MEDROL) 125mg IM/IVP
*[[Solu-Medrol|METHYLPREDNISOLONE (SOLU-MEDROL)]] 125mg IM/IVP
*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 (PROVENTIL) 2.5mg via updraft
*[[Albuterol|ALBUTEROL (PROVENTIL)]] 2.5mg via updraft
+/-  
+/-  
*IPRATROPIUM (ATROVENT) 0.5mg 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> ===
*EPINEPHRINE 1:10,000   0.5-1mg IVP (may repeat q 10 min)
*[[Epinephrine|EPINEPHRINE]] 0.1mg/1ml   0.5-1mg IVP (may repeat q 10 min)
*IV NS BOLUS 500-1000ml (maintain systolic BP > 90mm HG)
*IV NS BOLUS 500-1000ml (maintain systolic BP > 90mm HG)


[[Category:Medical|0502]]
[[Category:Medical|0502]]

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)


MODERATE (mild respiratory involvement)

+/-

  • IPRATROPIUM (ATROVENT) 0.5mg via updraft


SEVERE (stridor / airway involvement)

+/-

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)