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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.