ANAPHYLAXIS/ALLERGIC REACTIONS GUIDELINES FOR CARE 1. Assure ABCs. 2. Oxygen via non-rebreather mask. 3.

Consider intubation and hyperventilation with 100% oxygen for markedly decreased LOC, inability to maintain a patient airway, or for GCS < 8. 4. Attach cardiac monitor and pulse oximeter. 5. Start IV Ringer lactate to keep vein open. 6. If blood pressure normal: o Consider Benadryl 50 mg IM or slow IV push. 7. If hypotensive (systolic <90 mmHg) and patient has mild - moderate respiratory distress: o Open IV and infuse fluid bolus (500 ml for adults or 20 ml/kg for children.) o Elevate legs. o Administer Adrenaline 1:10,000 3-5 ml (dilute adrenaline 1:1000 ampoule in 10ml) and give slow iv. Watch for tahyarrythmias. o OR Administer Epinephrine 1:1,000 subcutaneously. (Adult: 0.3 ml / Pedi: 0.01 ml/kg.) 8. If refractory hypotension, or sever repspiratory distress: o Administer Adrenaline 1:10,000ml (dilute adrenaline 1:1000 ampoule in 10ml) and give slow iv. Watch for tahyarrythmias. o OR Administer Epinephrine 1:1,000 subcutaneously (Adult: 0.3 ml / Pedi: 0.01 ml/kg.) o Consider Dopamine drip starting at 2 µg/kg/minute and titrate to effect.