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🚑 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.

Clinical takeaway

IM epinephrine is the first-line and only life-saving drug — never delayed for antihistamines or steroids.

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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.

Worked calculation

The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.

Weight (to estimate epinephrine dose)60 kg
Hypotension/shockYes
Persists after two IM dosesYes
On a beta-blockerYes

Primary actionImmediate IM epinephrine 0.5 mg

  • First-line (immediate)IM epinephrine 0.5 mg (1 mg/mL) into the mid-outer thigh (vastus lateralis), repeatable in 5–15 min; do not delay for antihistamines/steroids
  • PositioningSupine with legs elevated (semi-recumbent if dyspneic); avoid sudden sitting up/standing
  • FluidsHigh-flow oxygen + rapid IV crystalloid 1–2 L to correct hypotension

Frequently asked questions

What is 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.
How is Anaphylaxis / Anaphylactic Shock Management calculated? What is the core formula?
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.
When is Anaphylaxis / Anaphylactic Shock Management used?
Emergency management of anaphylaxis and anaphylactic shock.
What are the key clinical points for Anaphylaxis / Anaphylactic Shock Management?
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.
What are the limits and cautions when using Anaphylaxis / Anaphylactic Shock Management?
For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
How is Anaphylaxis / Anaphylactic Shock Management calculated in practice? Can you show a worked example?
Inputs: Weight (to estimate epinephrine dose) 60 kg, Hypotension/shock Yes, Persists after two IM doses Yes, On a beta-blocker Yes → Result: Primary action Immediate IM epinephrine 0.5 mg(First-line (immediate): IM epinephrine 0.5 mg (1 mg/mL) into the mid-outer thigh (vastus lateralis), repeatable in 5–15 min; do not delay for antihistamines/steroids, Positioning: Supine with legs elevated (semi-recumbent if dyspneic); avoid sudden sitting up/standing, Fluids: High-flow oxygen + rapid IV crystalloid 1–2 L to correct hypotension)

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