12
Management
Second line: supplies and medications
• Automated external
defibrillator
• Laryngeal mask airways:
sizes 2, 3, 4, 5
• Suction machine and
tubing
• Cardiac arrest backboard
• Diphenhydramine
50 mg/mL
intravenously
• Cetirizine 10-mg
tablets, 5 mg/tsp liquid
• Ranitidine 25 mg/mL
intravenously
• Methylprednisolone
125-mg vial
• Prednisone 5- or 10-mg
tablets, prednisolone
syrup 15 mg/tsp
ird line: supplies and medications
• Electrocardiograph and
supplies
• Equipment for intubation
(for remote areas only)
• 5% dextrose in water
500 mL (for dopamine
infusion)
• Dopamine 200 mg/
5 mL intravenously
(1 ampule)
• Atropine 0.5 mg/mL
intravenously
Table 7. Anaphylaxis Emergency Cart (cont'd)
Basic supplies
Airway & intravenous
fluid support equipment Medications
Table 8. Anaphylaxis Treatment Protocol in the Physician's
Office
Immediate measures
1. Allergen Remove the inciting allergen, if possible
2. Airway Assess airway, breathing, circulation, and
orientation; if needed, support the airway using
the least invasive but effective method (eg, bag-
valve-mask)
3. Cardiopulmonary
resuscitation
Start chest compressions (100/min) if
cardiovascular arrest occurs at any time
4. Epinephrine intramuscular Inject epinephrine 0.3-0.5 mg (0.01 mg/kg for
children) intramuscularly in the vastus lateralis
(lateral thigh)
5. Get help Summon appropriate assistance in office
6. Position Place adults and adolescents in recumbent
position; place young children in position of
comfort; place pregnant patient on le side
7. Oxygen Give 8-10 L/min through facemask or up to
100% oxygen as needed; monitor by pulse
oximetry if available
