Pediatric emergency medicine trisk 1669 1669
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Anaphylaxis: Emergent Care
URL: />Authors: J. Lee, MD; T. Brown-Whitehorn, MD; N. Tsarouhas, MD; B.
Rodio, RN; L. Zielinski, RN; J. Molnar, CRNP; M. Lewis, CRNP; C.
Jacobstein, MD; J. Lavelle, MD
Posted: June 2006, last revised January 2019
ANAPHYLAXIS
Goals of Treatment
Early recognition, aggressive cardiopulmonary support, and immediate treatment
with IM epinephrine are essential in the evaluation and treatment of anaphylaxis.
CLINICAL PEARLS AND PITFALLS
Anaphylaxis is a life-threatening emergency, increasing in incidence
among children.
Rapid intervention is required for patients with stridor, hoarseness,
respiratory distress, and hypotension.
Epinephrine should be the medication priority in patients with
anaphylaxis.
Delayed administration of IM epinephrine may be associated with an
increased risk of severe and biphasic reactions.
Dermatologic involvement including urticaria is common, but not
required, and may be transient.
Hypotension and shock are uncommon among children with
anaphylaxis, however absence of cardiovascular involvement does not
exclude the diagnosis.
Antihistamines and systemic corticosteroids are considered adjunctive
therapies due to lack of data regarding efficacy.
Current Evidence
Anaphylaxis is a potentially life-threatening acute hypersensitivity reaction.
Reaction severity varies from mild urticaria to shock and death. Anaphylaxis is a
