Anaphylaxis

# Anaphylaxis
Patient with*** history of anaphylaxis, who presents with acute onset respiratory compromise or hypotension, with skin or mucosal involvement concerning for anaphylaxis. Suspect triggered by ***. Ddx includes but is not limited to acute generalized urticaria, angioedema, asthma exacerbation, panic attack, and shock.
Dx
- CBC w/ diff, CMP, INR, Lactate, Tryptase
Tx
- Airway – Albuterol, racemic epinephrine nebulizer
- Epinephrine initial management: 0.3 – 0.5 mg IM, repeat q5-15min for hypotension
- Epinephrine gtt: 0.1 mcg/kg/minute, with increase every 2 min by 0.05 mcg/kg/min to MAP >65
- IVF: ***L bolus
- H1: Benadryl 50 IV
- H2: Ranitidine 50 IV (for urticarial relief)
- Methylprednisolone 125 IV
- Telemetry, CPO, Airway management per ICU