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anaphylaxis

Emergency   (673 Views 8 Comments)
by Dacatster Dacatster (Member)

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Can you help a nurse out. I worked in ER for over 8 years awhile ago, for the life of me. I can not recall meds and doses of Anaphylaxis. I believe Epi is 1;1000 IM 1 amp q5 min, Ranitidine  ? , Solumedrol 60 mg IV , and Diphenhydramine 50 mg IV. Does that seem right? Thanks

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4,959 Visitors; 400 Posts

No, those doses are largely inappropriate and treatment should be based on individual presentation. You should consult a reputable evidence based medical site, I personally like UpToDate.

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16,724 Visitors; 1,531 Posts

Short answer- No.

This is a weird place to ask that question.  For one thing, a quick google search would give you better information than your current understanding.

 

Edited by hherrn

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Pixie.RN has 18 years experience as a MSN, RN, EMT-P and works as a ED/Trauma, Educator, IP/Nurse Epidemiologist.

7 Followers; 32 Articles; 126,363 Visitors; 12,938 Posts

Nope, seems wrong. Way too much epi. Typical epi dose is 0.3mg IM, not the whole ampule, and just once initially. We usually did ranitidine or famotidine if ordered, 50mg benadryl IV, and 125mg of solumedrol. It varies depending on presentation and provider order. 

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1 Follower; 11,842 Visitors; 1,319 Posts

Managed a few  anaphylactic reactions in the OR....at least 2 required 4 or 5 mg of epi followed by an infusion in addition to everything else (fluid, vasopressin etc.) Very few patients read the book...

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16,724 Visitors; 1,531 Posts

On 3/15/2019 at 8:44 PM, offlabel said:

Managed a few  anaphylactic reactions in the OR....at least 2 required 4 or 5 mg of epi followed by an infusion in addition to everything else (fluid, vasopressin etc.) Very few patients read the book...

5 mg of epi?  That is over 15 doses.  

In my last 2 days at work, I treated 2 cases.  Both responded well to a standard 0.3 mg dose.

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1 Follower; 11,842 Visitors; 1,319 Posts

58 minutes ago, hherrn said:

5 mg of epi?  That is over 15 doses.  

In my last 2 days at work, I treated 2 cases.  Both responded well to a standard 0.3 mg dose.

No...it was the dose the patient got. 

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renzlao has 13 years experience as a BSN, MSN, RN and works as a RN - Emergency.

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Here is a quick reference for yeah. This is emergency medicine. 

“First Line”

Epinephrine: Less severe reaction: 0.3 to 0.5 mg (0.01 mg/kg in children) = 0.3 to 0.5 mL of a 1:1,000 solution, (0.01 mL/kg in children), IM q20–30 min PRN, up to 3 doses. Life-threatening reactions: 0.5 mg (5 mL of a 1:10,000 solution) (for children: 0.05 to 0.10 mL/kg per dose) IV, slowly: q5–10 min as needed. 

Antihistamines: Diphenhydramine: an H1 blocker: 25 to 50 mg IV (IM or PO) q6h for 72 hours (children 1.25 mg/kg to 25 mg)

Cimetidine: an H2 blocker: 300 mg IV over 3 to 5 minutes (children 5 to 10 mg/kg per dose). We often give famotidine or ranitidine  

Corticosteroids: Methylprednisolone: 60 to 125 mg IV in adults (1 to 2 mg/kg in children) 

Edited by renzlao

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