Apply oxygen as prescribed using high flow oxygen via non-rebreather mask. Dyspnea, wheezing, and stridor are typical signs of anaphylactic shock. Prepare for the possibility of intubation or tracheotomy and have the equipment available if the patient goes into respiratory arrest.
Patients with anaphylactic shock typically have a feeling of “impending doom.” Decreasing anxiety will help the patient focus on breathing and following commands
Patients experiencing anaphylaxis may be placed in a supine position. This can aid in perfusion and oxygenation.
Methylprednisone (Solu-medrol) helps decrease the inflammatory response of the body. It will also decrease bronchial edema.
This drug is used during anaphylaxis because of its vasoconstrictive effects, reversing angioedema and hypotension. Stimulation of B2 receptors causes bronchodilation and reduces the release of inflammatory mediators. Epinephrine auto-injectors typically contain a dose of 0.3mg for IM administration. IV administration of epinephrine consists of a single dose of 0.1-0.25mg.
Diphenhydramine (Benadryl), 25-50mg IV push, is a histamine antagonist medication and should be administered every 15 minutes as ordered until the patient responds.
Educate the patient about the importance of wearing a medical alert tag identifying their potential allergens and anaphlaxis.
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