Paediatric Anaphylaxis Management 👶⚠️
The management of paediatric anaphylaxis is essentially the same as adult management, and thankfully the incidence rate of anaphylaxis in kiddies is lower! Even still, there are some important factors to remember in the recognition and management of anaphylaxis in our littlies:
🟢 Bronchospasm is the most common presenting feature of anaphylaxis for kids, followed closely by hypotension 💔
🟢 As per ANZCA, for children 12 and under, the paediatric management guideline should be followed 📝
🟢 Children older than 12 should be managed in line with adult guidelines 📑
The key to effective management of anaphylaxis is an organised and fast response to the situation. The DRSABCD style algorithm can be applied in this scenario as follows:
🟠DR - Danger and diagnosis/Response (and remove) stimulus ⚠️
🟠S - Send for help 🚨
🟠AB - Check and confirm, or secure the airway and administer 100% oxygen 💨
🟠C - Plan for large volume fluid resuscitation, elevate legs if hypotensive 🧃
🟠D - Drugs! Adrenaline boluses, repeat as needed and prepare infusion 💉
Algorithms for the immediate and refractory management of anaphylaxis in paediatrics, including adrenaline dosing recommendations, are available from ANZCA and should be utilised in these scenarios. 📊
It is important to note that if the child deteriorates into cardiac arrest, then management should follow the paediatric ALS algorithm ⚠️💔
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References:
ANZCA (2022) Perioperative anaphylaxis management guideline. https://www.anzca.edu.au/getattachment/e4bc8d58-5bff-49f0-8aa8-d673b6c8b058/Anaphylaxis-guideline-Background-Paper
Paediatric anaphylaxis immediate management guideline - https://www.anzca.edu.au/resources/professional-documents/endorsed-guidelines/anaphylaxis-card-2-paediatric-immediate-management.pdf
Paediatric anaphylaxis refractory management guideline - https://www.anzca.edu.au/resources/professional-documents/endorsed-guidelines/anaphylaxis-card-4-paediatric-refractory-managemen.pdf
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