This is an clinical management observer tool to allow peers to give feedback to colleagues on team management and compliance with adult or pediatric algorithms for anaphylactic emergencies.
Promptly assesses the acutely ill patient performing a systematic ABCDE (< 3 min) and gathers patient history
Identifies acute onset of illness; life-threatening airway and/or circulation problems; skin changes to make diagnosis and declares emergency to team
Calls for help. Lies patient flat. Raises patient's legs.
Gives Adrenaline. IM doses of 1:1000 in arterolateral aspect of middle third of the thigh (at 90 degrees to skin which should be stretched). (IV if experienced) (Repeats after 5 min if no better)
Adult: IM (0.5 mL); Child 12+: (0.5mL); Child 6-12: (0.3mL); Child < 6: (0.15mL);
Establishes Airway (high flow oxygen using mask with reservoir (>10 L min -1)
Gives IV Fluid challenge (if available) Adult 500-1000mL Child – crystalloid 20 mL/kg (stops IV colloid if possible cause of anaphylaxis)
Gives Chlorphenamine: Adult IV 10 mg; (Child 6-12: 5mg; 6months-6years: 2.5mg; <6 months: 250 micrograms/kg)
Gives Hydrocortisone Adult IV 200mg: (Child 6-12: 100 mg; 6months to 6 years: 50 mg; 6 months: 25 mg)
Monitors pulse oximetry, ECG and blood pressure
Re-evaluates status (ABCD approach) and response to therapy and communicates to team