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Anaphylaxis - Resuscitation Council (UK) Algorithm

  • 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.
    https://www.resus.org.uk/anaphylaxis/emergency-treatment-of-anaphylactic-reactions/

  • 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)<br> 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

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