Prehospital protocol pediatric anaphylaxis: Difference between revisions
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===Yes=== | ===Yes=== | ||
*IF (weight) | *IF (weight <25) | ||
**Give EpiPen Junior IM (0.15mg epinephrine 1:1000 IM) If auto injector is not available, give epinephrine 1:1000 (weight * 0.01) mg IM | **Give EpiPen Junior IM (0.15mg epinephrine 1:1000 IM) If auto injector is not available, give epinephrine 1:1000 (weight * 0.01) mg IM | ||
*IF (weight) | *IF (weight > 25) | ||
**Give EpiPen IM (0.3mg epinephrine 1:1000 IM) If autoinjector is not available, give epinephrine (1:1000) (weight * 0.01) mg | **Give EpiPen IM (0.3mg epinephrine 1:1000 IM) If autoinjector is not available, give epinephrine (1:1000) (weight * 0.01) mg IM | ||
===No=== | ===No=== | ||
'''Acute onset of symptoms and 2 or more of the following?''' | '''Acute onset of symptoms and 2 or more of the following?''' | ||
Revision as of 15:21, 1 July 2015
Perfom general assesment
- 100% O2 NRB
- Check Vital Signs
- Assist Ventilations with BVM as needed
Signs Symptoms of Anapylaxis?
Is there a known allergen exposure with hypotension or respiratory distress?
Yes
- IF (weight <25)
- Give EpiPen Junior IM (0.15mg epinephrine 1:1000 IM) If auto injector is not available, give epinephrine 1:1000 (weight * 0.01) mg IM
- IF (weight > 25)
- Give EpiPen IM (0.3mg epinephrine 1:1000 IM) If autoinjector is not available, give epinephrine (1:1000) (weight * 0.01) mg IM
No
Acute onset of symptoms and 2 or more of the following?
- Hypotension, cyanosis, delayed cap refill
- Dyspnea, wheezing, stridor, or respiratory distress
- Throat tightness or facial/lip/tongue swelling
- Widespread hives, itching, swelling
- Persistent vomitting or abdominal pain
- AMS, syncope, or decreased consciousness
Yes
- IF (weight) <25kg
- Give EpiPen Junior IM (0.15mg epinephrine 1:1000 IM) If auto injector is not available, give epinephrine 1:1000 (weight * 0.01) mg/kg IM
- IF (weight) > 25kg
- Give EpiPen IM (0.3mg epinephrine 1:1000 IM) If autoinjector is not available, give epinephrine (1:1000) (weight * 0.01) mg/kg IM
IV NS TKO, Cardiac Monitor, Pulse Oximetry
Give Diphenhydramine (weight * 1.0) mg IV/IM
Wheezing or Shortness of Breath?
2.5mg/3mL NS via Nebulizer may be administered
Recurent signs of Anaphylaxis?
If patient has continued signs of anaphylaxis and no epinephrine was given in the last 5 minutes then
- IF (weight) <25kg
- Give EpiPen Junior IM (0.15mg epinephrine 1:1000 IM) If auto injector is not available, give epinephrine 1:1000 (weight * 0.01) mg IM
- IF (weight) > 25kg
- Give EpiPen IM (0.3mg epinephrine 1:1000 IM) If autoinjector is not available, give epinephrine (1:1000) (weight * 0.01) mg/kg IM
Hypotension or Poor Perfusion?
Yes
- Give (weight * 20) mL/kg NS bolus and reassess.
- Repeat bolus x 3 times if continued signs of poor perfusion
Notify Recieving Hospital
- Continue transport, and frequent reassessments
- Contact online medical control if in need of further instructions