Treatment-anaphylaxis

• Epi: 0.5 mg IM (0.5 mL of 1 mg/mL solution) q5–15min as needed. For those who do not respond, IV infusion starting at 0.1 mcg/kg/min.

• Airway: suppl O2 ± intubation or cricothyroidotomy (if laryngeal edema); β2-agonists

• Fluid resuscitation w/ ≥1–2 L crystalloid (may extravasate up to 35% of intravasc volume)

• Antihistamines relieve hives & itching, no effect on airway or hemodynamics; H1RA (diphenhydramine 50 mg IV/IM)

• Methylprednisolone 1–2 mg/kg/d × 1–2 d for those who do not respond to epi

• Avoid unopposed α-adrenergic vasopressors