(step2CK)Bee sting에 의한 anaphylaxis일때의 처치는? 운영자 / 2005-09-16 11:43:18
General Measures
ABC Management
Oxygen
Intravenous Fluids
Nebulized Beta-Agonist (Albuterol)
A.Anaphylaxis with Airway Compromise
1.Epinephrine (1:1000 concentration = 1 mg/ml)
Intramuscular dosing preferred over subcutaneous
Repeat every 10 to 15 minutes prn up to 3 doses
2.Unresponsive to Epinephrine
Glucagon 1 mg IV if patient uses Beta-Blockers
Norepinephrine may also be considered
B.Urticaria, Pruritus or Flushing
Diphenhydramine (Benadryl) every 6 hours prn
C.Hypotension (due to vasodilitation and third spacing)
Fluid Resuscitation with isotonic saline (NS, LR)
Large volumes may be required
Pressors (e.g. Dopamine) may be required
Consider Epinephrine by continuous IV infusion
D.Respiratory distress
Nebulized Beta adrenergic agonist (e.g. Albuterol)
Consider Endotracheal Intubation
Consider aminophylline 5.6 mg/kg IV load over 20 min
Severe or persistent symptoms not resolved in 30 min
Hydrocortisone 5 mg/kg IV
Methylprednisolone (Solu-Medrol) every 6 hours
