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Copyright ©2001 BMJ Publishing Group Ltd. Emerg Med J 2001;18:393-395
Figure 1 Anaphylactic reactions: treatment for adults by first medical responders. *An inhaled {beta}2 agonist such as salbutamol may be used as an adjunctive measure if bronchospasm is severe and does not respond rapidly to other treatment. {dagger}If profound shock judged immediately life threatening give CPR/ALS if necessary. Consider slow intravenous (IV) adrenaline (epinephrine) 1:10 000 solution. This is hazardous and is recommended only for an experienced practitioner who can also obtain IV access without delay. Note the different strength of adrenaline (epinephrine) that may be required for IV use. {ddagger}If adults are treated with an EpiPen, the 300 {micro}g will usually be sufficient. A second dose may be required. Half doses of adrenaline (epinephrine) may be safer for patients on amitriptyline, imipramine, or {beta} blocker. [§]A crystalloid may be safer than a colloid.
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Copyright ©2001 BMJ Publishing Group Ltd. Emerg Med J 2001;18:393-395
Figure 2 Anaphylactic reactions: treatment for children by first medical responders. *An inhaled {beta}2 agonist such as salbutamol may be used as an adjunctive measure if bronchospasm is severe and does not respond rapidly to other treatment. {dagger}For profound shock judged immediately life threatening give CPR/ALS if necessary. Consider slow intravenous (IV) adrenaline (epinephrine) 1: 10 000 solution. This is hazardous and is recommended only for an experienced practitioner who can also obtain IV access without delay. Note the different strength of adrenaline (epinephrine) that may be required for IV use. {ddagger}For children who have been prescribed EpiPen, 150 {micro}g can be given instead of 120 {micro}g, and 300 {micro}g can be given instead of 250 {micro}g or 500 {micro}g. [§]Absolute accuracy of this small dose is not essential. {paragraph}A crystalloid may be safer than a colloid.
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Copyright ©2001 BMJ Publishing Group Ltd. Emerg Med J 2001;18:393-395
Figure 3 Anaphylactic reactions: treatment for adults in the community. *Ambulance will be equipped with oxygen, salbutamol, and fluids that may be used as adjunctive therapy. {dagger}If profound shock judged to be immediately life threatening give CPR/ALS if necessary. {ddagger} Half doses of adrenaline (epinephrine) may be safer for patients on amitriptyline, imipramine, or {beta} blocker. [§]If adults are treated with an EpiPen, the 300 {micro}g will usually be sufficient. A second dose may be required, but this should be considered ONLY if the patient's condition continues to deteriorate five minutes after the first dose. NB Remember the urgency of hospital transfer.
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Copyright ©2001 BMJ Publishing Group Ltd. Emerg Med J 2001;18:393-395
Figure 4 Anaphylactic reactions: treatment for children in the community. *Ambulance will be equipped with oxygen, salbutamol, and fluids that may be used as adjunctive therapy. {dagger}If profound shock judged to be immediately life threatening give CPR/ALS if necessary. {ddagger}For children who have been prescribed EpiPen, 150 {micro}g can be given instead of 120 {micro}g, and 300 {micro}g can be given instead of 250 {micro}g or 500 {micro}g. [§]Absolute accuracy of this small dose is not essential.
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Copyright ©2004 BMJ Publishing Group Ltd. Brown, S G A et al. Emerg Med J 2004;21:149-154 Figure 2 Observations and treatment for cases 1-3.
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Copyright ©2004 BMJ Publishing Group Ltd. Brown, S G A et al. Emerg Med J 2004;21:149-154 Figure 3 Case 4; electrocardiograph 15 minutes after onset of reaction, before starting treatment with adrenaline.
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