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Wheeless' Textbook of Orthopaedics
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Rx of Anaphylaxis



- See: Clevland Clinic - Managment of Latex Allergy and GMO Manual

- Management:
    - immediate NS 500-1000 ml IV; IV NS "wide open" til normotensive;
    - epinephrine 0.3mg (3ml of a 1:10,000 solution) IV immediately, or 0.3mg (0.3ml of a 1:1000 solution) SC immediately
           with repeated doses q10 to 15min if indicated;
           - if possible, IV infusion is better than SC;
    - salbutamol / ventolin 2.5mg/3ml NS by nebulizer;
    - diphenhydramine (Benadryl) 50mg IV, by direct injection;
    - hydrocortisone 250mg IV bolus, followed by 100mg IV q6hr;
    - ABG and O2 therapy by bag and mask as necessary; repeat ABG q30min;
    - if pH<7.2 in absence of respiratory acidosis, give 1 amp HCO3 (44.6 meq) IV;
    - consider H2 blocker;
    - intubate if necessary;




Intraoperative anaphylaxis due to exposure to latex (natural rubber) in children.











Original Text by Clifford R. Wheeless, III, MD.

Last updated by Clifford R. Wheeless, III, MD on Friday, February 15, 2008 6:38 pm