Difference between revisions of "Contrast medium reaction"

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(Expanded)
(Expanded)
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{|class="wikitable"
 
{|class="wikitable"
!rowspan=2| Indication<ref name=SURF/> !!rowspan=2| Medication<ref name=SURF/> !!rowspan=2| Route<ref name=SURF/> !!colspan=2| Dosage<ref name=SURF/> !!rowspan=2| Effect<ref name=SURF/>
+
!rowspan=2| Indication<ref name=SURF/> !!rowspan=2| Medication<ref name=SURF/> !!rowspan=2| Route<ref name=SURF/> !!colspan=2| Dosage<ref name=SURF/> !!rowspan=2| Time to effect<ref name=SURF/> || Repeat
 
|-
 
|-
 
! Adults !! Children
 
! Adults !! Children
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**≥20kg: 0.3 mg
 
**≥20kg: 0.3 mg
 
| Less than 5 min
 
| Less than 5 min
*Repeat every 5-10 min if needed
+
| Every 5-10 min if needed
 +
|-
 +
| Asthma
 +
| Salbutamol (Ventolin) or own bronchodilator
 +
| Inhalation
 +
|
 +
*5 mg
 +
*Usually 4-6 doses
 +
|
 +
*2-6 doses
 +
| Less than 5 min
 +
| Every 10 mins if needed
 +
|-
 +
| Hypoxia
 +
| Oxygen
 +
| Mask
 +
|colspan=2| >5 l/min
 +
| Almost immediate
 +
| Continuous
 +
|-
 +
| Altered level of consciousness or hypotension
 +
| Volume expander such as Ringer's
 +
| IV with pressure
 +
|colspan=2| 20mg/kg
 +
| Fast
 +
| As needed
 +
|-
 +
| All anaphylaxis cases
 +
| Antihistamine such as desloratadine (Clarinex/Aerius)
 +
| Oral
 +
| 10mg of desloratadine
 +
|
 +
*<6 years: 2.5mg desloratadine
 +
*6 - 12 years: 5 mg desloratadine
 +
| Within 30-60 minutes
 +
|-
 +
| All anaphylaxis cases
 +
| Glucocorticoid such as betamethasone or cortisol
 +
| Oral or intravenous
 +
|
 +
*5mg oral betamethasone or
 +
*8mg IV cortisol
 +
|
 +
*<6 years: 3
 
|}
 
|}
  
 
==References==
 
==References==
 
{{reflist}}
 
{{reflist}}

Revision as of 12:57, 22 May 2018

This page in a nutshell:
  • Adrenaline, 0.3-0.5mg in adults, given intramuscularly, is the most important initial therapy.[1]
  • Peripheral venous catheter and IV fluids are needed for everyone with anaphylaxis.[1]
  • Oxygen saturation, pulse and blood pressure are monitored.[1]


Indication[1] Medication[1] Route[1] Dosage[1] Time to effect[1] Repeat
Adults Children
  • Severe hives
  • Labored breathing
  • Hypotension
  • Altered level of consciousness
  • Severe abdominal pains and vomiting
Injection of adrenaline Intramuscular in lateral thigh 0.3 - 0.5 mg
  • 0.01 mg/kg, up to 0.5 mg
    • 10-20kg: 0.15 mg
    • ≥20kg: 0.3 mg
Less than 5 min Every 5-10 min if needed
Asthma Salbutamol (Ventolin) or own bronchodilator Inhalation
  • 5 mg
  • Usually 4-6 doses
  • 2-6 doses
Less than 5 min Every 10 mins if needed
Hypoxia Oxygen Mask >5 l/min Almost immediate Continuous
Altered level of consciousness or hypotension Volume expander such as Ringer's IV with pressure 20mg/kg Fast As needed
All anaphylaxis cases Antihistamine such as desloratadine (Clarinex/Aerius) Oral 10mg of desloratadine
  • <6 years: 2.5mg desloratadine
  • 6 - 12 years: 5 mg desloratadine
Within 30-60 minutes
All anaphylaxis cases Glucocorticoid such as betamethasone or cortisol Oral or intravenous
  • 5mg oral betamethasone or
  • 8mg IV cortisol
  • <6 years: 3

References