Anaphylaxis (Paed) Flashcards
(18 cards)
Recite the Anaphylaxis (Paed) CPG
Part 1
Recite the Anaphylaxis (Paed) CPG
Part 2
What is the first priority when anaphylaxis is suspected?
Stop the trigger – cease infusion, remove food, wash exposed skin.
Who must be transported to hospital per CPG?
Any patient with suspected, resolved or possible anaphylaxis, or any patient who received adrenaline for any reason.
Why is transport and monitoring essential?
Deterioration can occur suddenly and unpredictably.
What are the diagnostic criteria for anaphylaxis?
Sudden onset (<30 min or up to 4 hours) AND two or more of R.A.S.H.
- Respiratory distress
- Abdominal symptoms
- Skin/mucosal involvement
- Hypotension
What are two alternative single criteria for diagnosing anaphylaxis?
- Isolated hypotension following known antigen exposure
- Isolated respiratory distress following known antigen exposure
Should you let the patient sit or walk?
No, this can precipitate cardiovascular collapse.
What is the initial dose of IM adrenaline in paediatrics?
10 mcg/kg IM (max 500 mcg), repeat at 5-minute intervals if needed.
What if there’s an inadequate response to 2 doses of IM adrenaline?
Start adrenaline infusion at 0.05 mcg/kg/min, titrate to max of 1 mcg/kg/min (max 25 mcg/min).
What must never delay repeat adrenaline doses?
Additional therapies – they are concurrent, not priority.
What nebulised adrenaline dose is used for airway oedema or stridor?
5 mg nebulised adrenaline – consult for repeat dose if needed.
What bronchodilator therapies are used for bronchospasm?
Salbutamol, Ipratropium Bromide, Dexamethasone.
What are the salbutamol doses (neb & pMDI)?
12–15 yrs: Neb: 5 mg, pMDI: 4–12 doses
6–11 yrs: Neb: 2.5–5 mg, pMDI: 4–12 doses
2–5 yrs: Neb: 2.5 mg, pMDI: 2–6 doses
What are the ipratropium doses (neb & pMDI)?
12–15 yrs: Neb: 500 mcg, pMDI: 8 doses
6–11 yrs: Neb: 250 mcg, pMDI: 8 doses
2–5 yrs: Neb: 250 mcg, pMDI: 4 doses
What dose of dexamethasone is used?
600 mcg/kg IV or oral (max 12 mg) – IV route is MICA only.
What fluid is used for hypotension despite adrenaline?
Normal Saline IV (max 40 mL/kg) – titrate to response.
What is the dose of IV adrenaline for extremely poor perfusion or impending cardiac arrest?
1 mcg/kg IV/IO, repeat at 1-minute intervals, max 50 mcg per dose.
