Anaphylaxis Tx

• 1. Maintain airway: consider intubation

  2. Oxygen

  3. IVF resuscitation: NS 1-2 L boluses initially

  4. 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.

  5. Stridor: give racemic epinephrine nebs.

  6. Albuterol nebulized IH

  7. Diphenhydramine (H1-blocker), 50 mg IV or IM

  8. Ranitidine, 50 mg IV (H2-blocker)

  9. 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