Prehospital protocol pediatric anaphylaxis

Perfom general assesment

1. 100% O2 NRB
2. Check Vital Signs
3. Assist Ventilations with BVM as needed

Signs Symptoms of Anapylaxis?

Is there a known allergen exposure with hypotension or respiratory distress?

Yes

• IF (weight) <25kg
  • Give EpiPen Junior IM (0.15mg epinephrine 1:1000 IM) If auto injector is not available, give epinephrine 1:1000 (weight * 0.01) mg IM
• IF (weight) > 25kg
  • Give EpiPen IM (0.3mg epinephrine 1:1000 IM) If autoinjector is not available, give epinephrine (1:1000) (weight * 0.01) mg/kg IM

No

Acute onset of symptoms and 2 or more of the following?

1. Hypotension, cyanosis, delayed cap refill
2. Dyspnea, wheezing, stridor, or respiratory distress
3. Throat tightness or facial/lip/tongue swelling
4. Widespread hives, itching, swelling
5. Persistent vomitting or abdominal pain
6. AMS, syncope, or decreased consciousness

Yes

• IF (weight) <25kg
  • Give EpiPen Junior IM (0.15mg epinephrine 1:1000 IM) If auto injector is not available, give epinephrine 1:1000 (weight * 0.01) mg/kg IM
• IF (weight) > 25kg
  • Give EpiPen IM (0.3mg epinephrine 1:1000 IM) If autoinjector is not available, give epinephrine (1:1000) (weight * 0.01) mg/kg IM

Wheezing or Shortness of Breath?

2.5mg/3mL NS via Nebulizer may be administered

Recurent signs of Anaphylaxis?

If patient has continued signs of anaphylaxis and no epinephrine was given in the last 5 minutes then

• IF (weight) <25kg
  • Give EpiPen Junior IM (0.15mg epinephrine 1:1000 IM) If auto injector is not available, give epinephrine 1:1000 (weight * 0.01) mg IM
• IF (weight) > 25kg
  • Give EpiPen IM (0.3mg epinephrine 1:1000 IM) If autoinjector is not available, give epinephrine (1:1000) (weight * 0.01) mg/kg IM

Hypotension or Poor Perfusion?

Yes

1. Give (weight * 20) mL/kg NS bolus and reassess.
2. Repeat bolus x 3 times if continued signs of poor perfusion

Notify Recieving Hospital

1. Contact online medical control for further instructions