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Reference : NB Immunization Handbook, section IV-XII, appendix XV

Anaphylaxis : life-threatening allergic reaction which results in multiple body system abnormalities.

Signs and symptoms can usually be reversed by treatment with epinephrine.

 

SYMPTOMS (Cardinal features)

•Itchy, urticarial rash (90% of cases)
•Angioedema around face and mouth with itchiness, tearing, nasal congestion, facial flushing
•Respiratory symptoms : sneezing, coughing, wheezing, laboured breathing, upper airway swelling (hoarseness and difficulty swallowing)
•Hypotension: can progress to shock and collapse

Anaphylaxis management

History of anaphylaxis taken prior vaccination

Assess and manage ABCs

Call for help : one nurse on-site will be available to manage anaphylaxis.

Call 911 : Design someone to call 911

Epinephrine administration (PHN responsibility)- If 2 or more signs/symptoms OR If one or more signs/symptoms and previous history, give Epinepherine (1:1000) SC 0,01 ml/kg or per dosage table in unvaccinated limb; repeat dose if no improvement in 15 minutes

Share info with ambulance personnel

Epinephrine table

Age  Dose ml  Dose mg

2-6 mths  0.07  0.07 (minimum dose)

12 mths  0.10  0.10

18 mths-4 yrs  0.15  0.15

5 yrs  0.20  0.20

6-9 yrs  0.30  0.30

10-13 yrs  0.40  0.40

14 yrs and more  0.50  0.50 (maximum dose)