Severe allergic-like reaction / anaphylaxis

Recognize

• Diffuse edema or facial edema with dyspnea
• Diffuse erythema with hypotension
• Laryngeal edema with stridor and/or hypoxia
• Wheezing/bronchospasm with significant hypoxia
• Anaphylactic shock (hypotension + tachycardia)

Act — tap each step

1. 1Call code / activate emergency response
2. 2Preserve airway — suction if needed; consider intubation
3. 3Oxygen by mask 6–10 L/min
4. 4EPINEPHRINE IM 0.3 mg (0.3 mL of 1 mg/mL) lateral mid-thigh — repeat q5–15 min
5. 5If IV access + hypotensive: EPI IV 0.1 mg (1 mL of 0.1 mg/mL) slowly over 2–5 min
6. 6Rapid IV fluids — Normal Saline 1 L wide open
7. 7Trendelenburg / supine with legs up if hypotensive
8. 8Adjuncts: Diphenhydramine 25–50 mg IV, H2 blocker, methylprednisolone (does NOT replace epi)

Medications