Atlas · Plate XIII · Medical Emergencies · 06
Allergy and anaphylaxis
A mild reaction with rash, itching or hives is treated with oral diphenhydramine and observation. Anaphylaxis, with airway swelling, wheezing, hypotension and hives, needs 1 mg/mL epinephrine injected into the anterolateral thigh: 0.3 mg for adults and 0.15 mg for small children, repeated every 5-15 minutes if needed, followed by EMS, oxygen and monitoring. Screen for latex allergy on the health history.
High-yield facts · 5
- Mild allergy (rash, itching, hives): diphenhydramine 25-50 mg orally, monitor.T8
- Anaphylaxis: airway swelling, wheezing, hypotension, hives; give epinephrine IM in the anterolateral thigh: 0.3 mg adults, 0.15 mg small children (about 0.01 mg/kg).T8S26
- Epinephrine for anaphylaxis is the 1 mg/mL (1:1,000) concentration; it can be repeated every 5-15 minutes.T8
- After epinephrine: call EMS, oxygen, position supine (or seated if breathing is hard), monitor vitals, CPR if needed.T8S26
- Latex allergy screening questions include reactions to balloons, gloves, and foods such as banana, avocado, kiwi and chestnut.T2
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