Pediatric Anaphylaxis Algorithm ‘AdmiisterIM EPINEPHRINE. Eau = ES Te eroseatil cote Bete ne) eae ats ‘Never administer the iM preperation af epinephrine (1mg/imt) ++ Epinephrine, salbutamol or antihistamine may have See Eo 1-5 min Respiratory symptoms: Sting postion “Administer high Now O, consider need for intubation \fsridoror upper arway obstruction give nebuzedepineptine Ifwheez or lower arway obstruction, guenebulized salbutamol Hypotension or poor perfusion/decreased LOC: + Supine pesiion (Donets uo) * Secure large bore W or aban intraosseous 10) neces "Bolus NS 20 mL/kg MO rapid push -roimproveent. give 2nd des oft EPINEPHRINE Respiratory * Repeat nebulzedeoinephine (upper airway symptoms: obstruction or salbutamol Gower airway obstruction) + Prepazefor ficult away intubation ‘Hypotension + 2nd bolus NS, 20 kg NO rapid push ‘or LOC: "+ Prepare for posible epinephrine infusion {Gee Drug Dosing Binder for details) fo improvernen, give 3 dose of1M EPINEPHRINE Respiratory + Concer nebulized epinephrine or saibutarat ‘symptoms: » Consider WV hydrocortisone Disposition Uiesshdeadh acsceoreltee hase Refer to TREK Anaphylass Bottom Line econmensatons rete} fo ute’ eas. Hypotension «Start epinephrine infusion 0.05 mea/kg/min ‘er LOC: strate up by 0.02 meg/Kg/minte effect Norepinephrine infusion (er persistent ) ‘Stara 0.05 meg/leg/min trate up by 002 meg/kg/min te effect (MAX? meg/kg/mia) (Glucagon bol (for perzsten anephylassrmptoms or patients on beta Blocks) ‘Dose: 20-30 mep/kghdose (MAK mg) Movers minutes, followed by infsion of {5-15 megimin trated torical eect