Anaphylaxis Tx
Maintain airway: consider intubation
Oxygen
IVF resuscitation: NS 1-2 L boluses initially
Epinephrine, 0.3 - 0.5 ml (1:1000), IM or SC 0.2-0.5 mg q5min. In elderly or in shock: dilute 0.1 cc or 1:1000 in 10 cc NS, then give it IV over 5-10 min.
Stridor: give racemic epinephrine nebs.
Albuterol nebulized IH
Diphenhydramine (H1-blocker), 50 mg IV or IM
Ranitidine, 50 mg IV (H2-blocker)
Methylprednisolone, 125 mg IV or dexamethasone 10-40 mg IV
In case of shock/respiratory arrest/airway obst:
Give Epi, 1 mL in 10 mL x 5 - 10 min
Hypotension refractory to epinephrine: give Glucagon, 1 mg IV