Advanced treatment 

When skills and necessary equipment are available, the following are considered:

Once Adrenaline has been administered: 

• Establish an airway and give the highest dose of oxygen available using a reservoir mask.
• In the presence of hypotension or shock give a rapid IV fluid bolus (10 mL/kg in a child or 500 – 1 000 mL in an adult) and monitor the response. If IV access is not possible, gain IO access.
• Ensure a further dose of IM adrenaline is administered after 5 minutes if breathing or circulation symptoms persist.

Continue to monitor their vital signs throughout, as equipment allows.

NOTE: Antihistamines are not recommended as part of the initial emergency treatment for anaphylaxis. ‍

When skills & equipment available:

• Establish airway
• High flow oxygen
• IV fluid challenge

Monitor:

• Pulse oximetry
• ECG
• Blood pressure