Rash

    • First, make sure this is not an anaphylactic reaction.

    • Look for urticarial rash with associated SOB, wheezing, laryngeal edema, and hypotension.

    • If these Sx are present, consider the following:

      • Large bore (16 gauge) access for IVF

      • Epinephrine, 0.5 mg (1:1000) SQ or IV (dilute in 10 mL saline.

      • Benardryl, 50 mg IV or 50 - 100 mg IM

      • Hydrocortisone, 250 mg IV

      • Intubation if airway is compromised

    • The most common cause of rashes inpatient is a drug reaction, so review medication list (MAR)

      • Hold any medication that may be the cause if this is not an essential medicaiton

      • Benadryl, 25 - 50 mg PO q6 - 8 hr PM; Atarax, 25 mg PO q6 - 8 hr PM; Allegra, 180 mg PO daily; or Claritin, 10 mg PO daily, if itching is present.

      • Corticosteroid creams or PO steroids, if severe.

    • Consider dermatology consult or allergy consult (for desensitization) in AM.