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Anaphylaxis Flowchart

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31 views

Anaphylaxis Flowchart

Uploaded by

jerus2023
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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Anaphylaxis1

ANY ONE of the following could indicate anaphylaxis


• Difficult/noisy breathing • Wheeze or persistent cough
• Swelling of tongue • Persistent dizziness or collapse
• Swelling/tightness in throat • Pale and floppy (young children)
• Difficulty talking/hoarse voice • Vomiting and/or abdominal pain - for
insect stings/bites
• Any acute onset: hypotension, bronchospasm or upper airway obstruction, OR
illness with skin features + respiratory/cardiovascular or persistent severe GI
symptoms

IMMEDIATE ACTION
• Remove allergen if still present
• Call for help
• Lay patient flat - do not allow to stand

Give intramuscular ADRENALINE (EPINEPHRINE) without delay


Deep IM into outer mid-thigh
Repeat 5 minutely as needed

• CPR if needed

When able Adrenaline (epinephrine) doses


• Monitor HR, BP, RR, SpO2
Age (years) Weight (kg) Adrenaline 1:1,000
• Give O2
<1 < 7.5
• Support airway 0.1 mL
1–2 10
• IV access - adults + hypotensive children 2–3 15 0.15 mL
4–6 20 0.2 mL
If hypotensive 7–10 30 0.3 mL
• Give IV sodium chloride 0.9% 10–12 40 0.4 mL
20 mL/kg RAPIDLY > 12–adult > 50 0.5 mL

Additional measures MO/NP may consider


• Adrenaline (epinephrine) infusion - on advice of emergency medicine/critical care specialist
• If upper airway obstruction - nebulised adrenaline (epinephrine) ± intubation/cricothyrotomy
• If persistent hypotension/shock - sodium chloride 0.9% (max. 50 mL/kg in first 30 minutes)
• If persistent wheeze - bronchodilators, prednisolone or hydrocortisone

For detailed management, see Anaphylaxis, p. 82

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