YHOVN 2 năm trước

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Situation	Intervention	Comments
Systemic anaphylaxis	Epinephrine 1:1,000, 0.3 cc SC, repeat at 5-10 min intervals Diphenhydramine 25-100 mg IV	Repeat doses of diphenhydramine may be required for
Special Problems	H2-blocker^ Hydrocortisone 100-250 mg IV q6h	symptom relief
Upper airway	Nebulized racemic epinephrine, 0.3 ml	Administer oxygen;
obstruction	diluted in 3 ml 0.9% NaCl	consider tracheal intubation and mechanical ventilation
Bronchospasm	Epinephrine 1:1,000, 0.3-0.5 ml SC, may repeat at 5-10 min intervals, or Albuterol, 1-2 puffs metered dose inhaler or 2.5-5 mg nebulized in 2-3 ml 0.9% NaCl, or Aminophylline, 6 mg/kg IV initially (see Table 4.4)	With severe bronchospasm or hypotension, consider epinephrine, 1:10,000, 0.5-1.0 ml IV (rather than SC)
Shock	Volume resuscitation with 0.9% NaCl >500 ml rapidly, with or without vasopressors Dopamine 5-20 ^g/kg/min, titrated to blood pressure, or Norepinephrine, 2 ^g/min, titrated to blood pressure Patients on ^-blockers who are hypotensive may also be treated with glucagon, 1 mg IV
IV, intravenous; SC, subcutaneous ^Ranitidine: 50 mg IV Famotidine: 20 mg IV Cimetidine: 300 mg IV