Anaphylaxis Algorithm
Anaphylaxis is a severe, life-threatening , generalised or systemic hypersensitivity reaction (Resuscitation Council UK )
ANAPHYLACTIC REACTION
Airway Breathing Circulation Disability Exposure
Diagnosis → look for Acute onset of illness Life threatening Airway and / or Breathing and / or circulation problems* And usually skin changes
Life threatening problems* Airway → swelling , hoarseness , stridor Breathing → rapid breathing , wheeze , fatigue , cyanosis , SpO2 < 92 % , confusion Circulation → pale , clammy , low BP , faintness , drowsy / coma
Call for help Lie patient flat Raise patients leg
ADRENALINE
AFDRENALINE → GIVE IM Unless experienced with IV
IM doses of 1 : 1000 Adrenaline ( Repeat after 5 mins if no better ) Adult → 500 micrograms IM ( 0.5 ml ) Child > 12 yrs → 500 micrograms IM ( 0.5 ml ) Child 6-12 yrs → 300 micrograms ( 0.3 ml ) Child < 6 yrs → 150 micrograms ( 0.15 ml )
Adrenaline IV to be given only by experienced specialists Titrate : Adults 50 micrograms ; Children 1 micrograms / kg
IV fluid Challenge
Adult → 500 – 1000 mL Child → crystalloid 20 mL / kg Stop IV colloid if this might be the cause of anaphylaxis
When skills and equipment available Establish airway High flow Oxygen IV fluid challenge Chlorphenamine Hydrocortisone Monitor Pulse oximetry ECG Blood pressure
Adult or child > 12 ——–> child 6-12 yrs ————-> Child 6 month to 6 yrs -> Child < 6 months ———>10mg 5 mg 2.5 mg 250 mcgm/kg Hydrocortisone-200 mg 100 mg 50 mg 25 mg
Reproduced with the kind permission of Resuscitation Council UK March 2008
For further information please visit https://www.resus.org.uk/anaphylaxis/
Links and Resources
Anaphylaxis charity helping people with severe allergies https://www.anaphylaxis.org.uk/
National Allergy Strategy Group working to improve NHS allergy services https://www.nasguk.org/
Action against allergy https://actionagainstallergy.org/
British Society for Allergy and Clinical Immunology – for healthcare professionals https://www.bsaci.org/
