Allergic Reaction Anaphylactic Shock: Difference between revisions
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=== <span style="color: green;">MILD (urticaria, no respiratory involvement)</span> === | === <span style="color: green;">MILD (urticaria, no respiratory involvement)</span> === | ||
* | *[[Antihistamines|DIPHENHYDRAMINE (BENADRYL)]] 25-50mg IM/IVP | ||
*Consider METHYLPREDNISOLONE (SOLU-MEDROL) 125mg IM/IVP if the speed of reaction appears rapid. | *Consider [[Corticosteroids|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> === | ||
* | *[[Antihistamines|DIPHENHYDRAMINE (BENADRYL)]] 25-50mg IM/IVP | ||
*METHYLPREDNISOLONE (SOLU-MEDROL) 125mg IVP/IM | *[[Corticosteroids|METHYLPREDNISOLONE (SOLU-MEDROL)]] 125mg IVP/IM | ||
*FAMOTIDINE (PEPCID) 20mg/50ml IVPB | *[[Antihistamines|FAMOTIDINE (PEPCID)]] 20mg/50ml IVPB | ||
*EPINEPHRINE UPDRAFT (1:1,000 + 2ml NS) | *[[Adrenergics|EPINEPHRINE]] UPDRAFT (1:1,000 + 2ml NS) | ||
*ALBUTEROL (PROVENTIL) 2.5mg via updraft | *[[Bronchodilators|ALBUTEROL (PROVENTIL)]] 2.5mg via updraft | ||
+/- | +/- | ||
*IPRATROPIUM (ATROVENT) 0.5mg via updraft | *IPRATROPIUM (ATROVENT) 0.5mg via updraft | ||
| Line 28: | Line 28: | ||
=== <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) | *[[Adrenergics|EPINEPHRINE]] 1:1,000 0.3-0.5mg IM (may repeat q 10min) | ||
* | *[[Antihistamines|DIPHENHYDRAMINE (BENADRYL)]] 50mg IM/IVP | ||
*METHYLPREDNISOLONE (SOLU-MEDROL) 125mg IM/IVP | *[[Corticosteroids|METHYLPREDNISOLONE (SOLU-MEDROL)]] 125mg IM/IVP | ||
*FAMOTIDINE (PEPCID) 20mg/50ml IVPB | *[[Antihistamines|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 | *[[Bronchodilators|ALBUTEROL (PROVENTIL)]] 2.5mg via updraft | ||
+/- | +/- | ||
*IPRATROPIUM | *[[Bronchodilators|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) | *[[Adrenergics|EPINEPHRINE]] 1:10,000 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]] | ||
Revision as of 19:51, 16 March 2019
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 (1:1,000 + 2ml NS)
- ALBUTEROL (PROVENTIL) 2.5mg via updraft
+/-
- IPRATROPIUM (ATROVENT) 0.5mg via updraft
SEVERE (stridor / airway involvement)
- EPINEPHRINE 1:1,000 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 1:10,000 0.5-1mg IVP (may repeat q 10 min)
- IV NS BOLUS 500-1000ml (maintain systolic BP > 90mm HG)