Suspect Anaphylaxis as a cause of dyspnea if EITHER:
- generalized itching, hives, flushing; OR swollen lips, tongue, uvula.
- history of exposure to a likely allergen; PLUS either persistent vomiting/abdominal cramps, or hypotension.
- ? Stridor (if upper airway obstruction)
- ? Wheezes, and/or Prolonged Expiratory Phase (if bronchospasm)
- Epinephrine 1:1,000 (1 ml. ampule = 1 mg), 0.5 mg, IM
- Peds 0.01 mg/kg
- EpiPen = 0.3 mg
- Repeat in 5-15 min
- Consider IV Normal Saline, in case shock ensues
- Observe several hours (maybe send to E.D.)
- Rx high-dose Prednisone x3d to prevent possible biphasic reaction
See posting Acute Dyspnea – 3.