General Approach to All Pediatric Patients

Allergic Reactions - Pediatric

Basic Life Support

  • Assist patient in self-administration of previously prescribed epinephrine (via auto injector)
  • Nothing by mouth

Advanced Life Support

  • If Moderate or Severe symptoms, perform Full Pediatric ALS Assessment and Treatment

Mild Reaction (Itching/Hives)

  • Diphenhydramine (Benadryl) 1 mg/kg IV (Maximum 50 mg)
    • May be administered IM if no IV access available

Moderate Reaction (Dyspnea, Wheezing, Chest tightness)

  • Albuterol (Proventil) 2.5 mg/3 ml via and Ipratropium Bromide 0.02% (Atrovent) 0.5 mg/2.5 ml via nebulizer
    • Repeat Albuterol (Proventil)/Ipratropium Bromide (Atrovent) X 2 for continued wheezing
  • Diphenhydramine (Benadryl) 1 mg/kg IV (Maximum 50 mg)
    • May be administered IM if no IV access available
  • Methylprednisolone (Solumedrol) 2 mg/kg IV or IM (Maximum individual dose 60 mg)

Severe Reaction (anaphylactic shock, stridor, severe respiratory distress)

  • Epinephrine 1:1,000 solution 0.01mg/kg IM (max dose 0.3mg)
    • Massage injection site vigorously for 30-60 seconds
    • Repeat Epinephrine if signs of severe reaction or shock persist after initial dose
  • Albuterol (Proventil) 2.5 mg/3 ml and Ipratropium Bromide 0.02% (Atrovent) 0.5 mg/2.5 ml via nebulizer
    • Repeat Albuterol (Proventil)/Ipratropium Bromide (Atrovent) X 2 for continued wheezing
  • Diphenhydramine (Benadryl) 1 mg/kg IV (Maximum 50 mg)
    • May be administered IM if no IV access available
  • Methylprednisolone (Solumedrol) 2 mg/kg IV or IM (Maximum individual dose 60 mg)