Occupational Health Clinic

Patila Pammana, Wajo South Sulawesi Indonesia

Ph. +62485-22471 Ext.112 Fax. +62485-22473 PT. ENERGI SENGKANG
PO BOX.141

ANAPHYLACTIC SHOCK
TREATMENT
Conscious : Comfortable position
Unconscious : Supine, slightly head-down

Keep the airway open (prepared for intubation

and cricothyrotomy if necessary)

Oxygen 5-10 L/min, If bronchospasm Bronchodilator

If no breathing CPR

IV line NaCl 0,9% 0,5 - 1 L / 30 min, adjust with

Blood pressure and urine output after then.

OPTIONAL- SEQUENCE :
1. ADRENALIN / EPINEPHRINE
Mild Reaction : 0,3 - 0,5 ml 1:1000 IM/SC or 0,01 ml/kgBW
additional 0,2 - 0,3 ml near port d’entry.
Severe Reaction : - 5 ml 1:10.000 IV/via endotracheal, repeat every 10 min
- Drip: 1 ml 1:1000 with 250 ml Dex 5%, rate 1- 4ug/min
2. ANTIHISTAMINE : Diphenhydramine (delladryl 50 mg IM/IV) or
Pheniramine hydrogen maleate (avil 25 – 50 mg IM or 25 mg IV/Min)
3. GLUCOCORTICOID: Hydrocortison (solu-cortef) 100 - 250 mg IV or
Methylprednisolon (solu-medrol:1mg/KgBW) 50 -100 mg IV/IM
may repeat 1-4 hourly
4. B-AGONIST
Mild Bronchospasm : Ventolin nebulizer 2,5 mL in 2 - 3 ml NaCl or
Ventolin inhaler 1- 2 puff or
Bricasma Inj. 0,25 - 0,5 mg SC/IM/IV
Severe Bronchospasm : Aminophylline 6 mg/kg in 50 - 100 mL bolus over 30 min
(may drips/diluent) follow by maintenance dose 0,5-1mg/kg/h
VITAL SIGN MUST BE MONITORED CLOSELY EVERY 5 MINUTES
Adapted from CURRENT Emergency Diagnosis & Treatment  upik