ANAPHYLAXIS
Last Updated : 12/21/2010
Swati Gadewar (Kolpuru)
1.    First the basic principle, take care of airway, breathing and circulation
2.    Provide 100% oxygen
3.    Endotracheal intubation if there is complete airway obstruction
4.    Epinephrine: 0.01 ml/kg  (1:1000 dilution) subcutaneously to a maximum of 0.5 ml. Repeat at 10 to 20 minute interval. If no response administer epinephrine intravenously as a 1:10,000 solution at a rate of 0.1 ml/kg over 1-2 minutes.
5.    Fluid bolus 20ml/kg if there is hypotension. Repeat if necessary
6.    H1-receptor antihistamines such as diphenhydramine, 0.5-1.5 mg/ kg or hydroxyzine 0.5-1 mg/kg should be given either IV, IM or by mouth
7.    H2- receptor antihistamines such as cimetidine can be given in refractory cases.
8.    Hydrocortisone, 8-9mg/kg or methylprednisolone, 2-3mg/kg should be given at 4-6-hour intervals.
9.    Albuterol, aminophylline or other inhaled beta agonists are useful in the treatment of bronchospasm refractory to epinephrine
10.    In stings and drug injections tying a tourniquet proximal to the site may slow further absorption.
11.    Admit the patient if there is airway obstruction, shock or respiratory distress.





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First Created : 2/23/2001

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