11
Î SS 20: Individualize the duration of direct observation and monitoring
after anaphylaxis but provide longer periods of observation for those
patients with a history of risk factors for severe anaphylaxis (eg,
asthma, previous biphasic reactions, or protracted anaphylaxis) for
≥4-8 hours. (S-C)
Î SS 21: Prescribe AIE for patients who have experienced an anaphylactic
reaction and for those at increased risk for anaphylaxis. (S-C)
Î SS 22: Provide patients at risk for anaphylaxis with an action plan
instructing them on how to manage an episode of anaphylaxis,
including administration of epinephrine (R-C)
Table 7. Anaphylaxis Emergency Cart
Basic supplies
Airway & intravenous
fluid support equipment Medications
First line: required supplies and priority medications
• Written emergency
protocol
• Flow chart for recording
times and events
• Stethoscope
• Sphygmomanometer,
blood pressure cuffs
(infant, child, adult,
obese adult)
• Watch or clock
• Gloves, preferably
without latex
• Synthetic tape
• Alcohol swabs
• Tourniquets
• Indwelling intravenous
catheters: gauge 14, 16,
18, 20, 22)
• Intravenous butterfly
needles: gauge 19, 21,
23)
• Syringes: 1, 10, 20 mL
• Needles (1-2 inches):
18, 21, 23 gauge
• Macro-drip
administration sets
• Extension tubing
• T-connectors
• 3-way stopcocks
• Arm boards (2-4 sizes)
• Bag-valve-mask, self-
inflating with reservoir
(eg, Ambu bag ) for adult
and child (preferably
without latex)
• Disposable face masks
(infant, toddler, child,
adult)
• Oropharyngeal airways:
6, 7, 8, 9, 10 cm
• Nasal pharyngeal airway:
6, 7, 8, 9 mm
• O
2
extension tubing
• O
2
nasal cannula
• Macro-drip
administration set
(10-15 drops/mL) and
connection tubing
• Intravenous pole or
suitable substitute
• Pulse oximeter
• Twin-jet nebulizer, face
mask, tubing
• Epinephrine 1:1,000
– 3 ampules or 1
multidose vial
• O
2
E-cylinder 2 and
wrench; >1,100 psi
• 0.9% normal saline
(2 1-L bags)
• Albuterol inhalational
solution 0.5%
• Glucagon 1 mg/mL
(2 vials)
