A 24yo pt presented with anaphylactic shock. What would be the dose of adrenaline?
a. 0.5ml of 1:1000
b. 0.5ml of 1:10000
c. 1ml of 1:500
d. 5ml of 1:1000
e. 0.05ml of 1:100
answer: A
Management
-
immediate initial management (call for help and perform concurrently)
give 0.5 mL of 1:1,000 epinephrine IM to lateral thigh (0.01 mL/kg up to 0.4 mL for children)
ƒremove causative agent if possible
if severely compromised ABC or LOC, consult ICU immediately
otherwise, provide 100% O2 through mask, give bolus 1,000 mL (20 mL/kg for children) crystalloid IV, then reassess; if IV access difficult, give fluid through intraosseous route
ƒhave continuous pulse oximetry and telemetry monitoring
ƒfrequently monitor BP -
secondary treatment
ƒdiphenhydramine (Benadryl®) 50 mg IM or IV q4-6h
ƒmethylprednisolone 50-100 mg IV (dose depending on severity)
ƒsalbutamol (Ventolin®) via nebulizer if bronchospasm