Anaphylaxis

IM adrenaline first

Adrenaline IM

>12 y
0.5 mg (0.5 mL of 1:1000)
6–12 y
0.3 mg
6 m–6 y
0.15 mg
<6 m
0.1–0.15 mg

Supportive

  • High-flow O₂
  • Lay flat, legs up (sit if SOB)
  • Crystalloid 500–1000 mL (20 mL/kg paeds)
  • Repeat adrenaline every 5 min

Refractory

  • IV adrenaline 0.05–0.5 mcg/kg/min
  • Nebulised adrenaline if stridor
  • Glucagon 1 mg IV if on β-blocker

After

  • Tryptase at 0, 1–2 h, ≥24 h
  • Observe ≥6 h
  • 2 auto-injectors + allergy referral
WardRound

WardRound

Clinical Decisions in Seconds