🚑 Anaphylaxis / Anaphylactic Shock Management
Compute the weight-based IM epinephrine dose and give positioning, fluids and follow-on steps by hypotension/refractory/beta-blocker status. Instant, browser-side.
Anaphylaxis / Anaphylactic Shock Management
Weight (to estimate epinephrine dose) (kg)
Hypotension/shock
Persists after two IM doses
On a beta-blocker
When to use
Emergency management of anaphylaxis and anaphylactic shock.
How it works
IM epinephrine 0.01 mg/kg (adult max 0.5 mg, child max 0.3 mg) into the mid-outer thigh, repeatable every 5–15 min. Hypotension → supine with legs up + oxygen + rapid crystalloid 1–2 L. Persisting after two IM doses → IV epinephrine infusion (monitored). On a beta-blocker and refractory → glucagon.
Key points
- IM epinephrine is the first-line and only life-saving drug — never delayed for antihistamines or steroids.
- Antihistamines (H1 ± H2) and corticosteroids are adjuncts only and do not replace epinephrine.
- Watch for biphasic reactions requiring observation; discharge with an epinephrine auto-injector and trigger-avoidance education.
- Glucagon is the option when a beta-blocked patient responds poorly to epinephrine.
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.