Management of anaphylaxis in children.
Anaphylaxis is a severe, life-threatening immunoglobulin E (IgE)-mediated hypersensitivity reaction. The key to successful management of anaphylaxis involves rapid diagnosis, assessment, and early initiation of therapy. Epinephrine is the undisputed initial therapy for anaphylaxis, and its administration should never be delayed. In most cases, additional interventions such as oxygen therapy, fluid resuscitation, beta-agonists, antihistamines, and corticosteroids should be strongly considered. Although hospital course must be individualized to meet each patient's needs, a minimum of 4 to 6 hours of observation period after complete symptom resolution may be reasonable to monitor for recurrence of symptoms and biphasic reaction. Before discharge, every patient should receive patient education about anaphylaxis, a prescription for self-injectable epinephrine, and instructions for follow-up care.
Liberman
Danica B
DB
Division of Emergency Medicine, Children's National Medical Center, Washington, DC 20010, USA. dliberma@cnmc.org
Teach
Stephen J
SJ
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000420:Albuterol / Q000627:therapeutic use; D000707:Anaphylaxis / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D001993:Bronchodilator Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D019468:Disease Management; D042241:Early Diagnosis; D004630:Emergencies; D004636:Emergency Service, Hospital; D004837:Epinephrine / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D005392:First Aid; D005440:Fluid Therapy; D005934:Glucagon / Q000627:therapeutic use; D006633:Histamine Antagonists / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D008297:Male; D010102:Oxygen Inhalation Therapy; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
D000305:Adrenal Cortex Hormones; D001993:Bronchodilator Agents; D006633:Histamine Antagonists; D014662:Vasoconstrictor Agents; D005934:Glucagon; D000420:Albuterol; D004837:Epinephrine