CP01 Emergency Treatment of Anaphylactic Reactions - Devon ...

5.4 Treatment must not be delayed while waiting for an ambulance to arrive.
5.5 Reassure the patient.
5.6 Place the patient in a comfortable position taking into account the following factors:
If the person has low blood pressure and / or reports feeling faint- lie the patient down
flat, with or without leg elevation. If the person reports feeling faint, do not sit or stand
them up (this can cause a cardiac arrest)
A person with breathing difficulties may prefer to sit up to make breathing easier
If the person is breathing but unconscious, place them on their side in the recovery
position (NB pregnant patients should lie on their LEFT side to prevent caval
compression).
5.7 Remove the trigger allergen if possible (i.e. stop the administration of a medication, remove
the stinger from a bee sting). If food is the suspected trigger, DO NOT attempt to induce
vomiting. Treatment must NOT be delayed if the removal of the trigger is not feasible.
5.8 Early administration of intramuscular adrenaline (epinephrine) is the treatment of choice in
the management of anaphylactic shock.
Use ADRENALINE (epinephrine) injection 1:1000 (1mg/ml)
The dose for adults and children over 12 years is 500micrograms
(0.5ml of Adrenaline 1:1000)
Administer intramuscularly into the anterolateral aspect of the middle third of the thigh.
(Refer to SOP MM28 Safer Use of Injectables)
Administer the intramuscular injection with the needle at a 90º angle to the skin. The skin
should be stretched not bunched
Record the TIME that the dose was administered in the clinical notes
In the absence of clinical improvement, repeat every 5 minutes (until paramedics arrive).
For further information, consult a Summary of Product Characteristics for an adrenaline
injection at www.medicines.org.uk/emc/
5.9 Oxygen should be administered as soon as it is available. Oxygen should be administered
using a mask with an oxygen reservoir using high flow oxygen (10 to15 litres/minute) to
prevent the collapse of the reservoir during inspiration. (In life-threatening emergencies a
prescription for oxygen is not necessary when acting in accordance with this protocol, but
subsequently documented of treatment administered must be recorded).
5.10 Patients who have been administered adrenaline (epinephrine) as first line treatment must
be transferred to an acute Trust hospital as soon as possible where monitoring and further
treatment (if appropriate) can be provided by paramedics and Accident and Emergency
clinicians.
5.11 Clearly document the following information the patient’s electronic medical records:
Presenting acute clinical features of suspected anaphylactic reaction
The time of onset of the reaction
The circumstances immediately before the onset of symptoms to help identify the
possible trigger
CP 01 - Protocol for the Emergency Treatment of Anaphylactic Reactions
Approved by Drugs and Therapeutics Committee: March 2014
Review Date: March 2016 Page 6 of 8