Anaphylaxis-

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.
Lung Exam:
  • ? Stridor (if upper airway obstruction)
  • ? Wheezes, and/or Prolonged Expiratory Phase (if bronchospasm)

Treatment:

  • 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.