Allergic Reactions

1. Urticaria
- hives
- Treat with Benadryl 1mg/kg/ dose max 50 mg or Atarax 1 mg/kg/dose
- H2 Blockers (ie Zantac 3 mg/kg/day div BID)
- NO Steroids!!(only for chronic urticaria, >2 weeks of symptoms)
- Remind parents sx may persists and be intermittent for up to 14 days

2. Anaphylaxis
- Symptoms may include urticaria, sensation of generalized warmth and of impending
doom, nausea, vomiting, abdominal pain, faintness due to hypotension, dyspnea,
hoarseness, stridor, wheezing, edema of airway components and/or obstruction
- ABCs
- Epinephrine 0.01 ml/kg up to max of 0.5 ml of a 1:1000 solution IM
- Benadryl
- H2 blockers
- Solumedrol IV 2 mg /kg (125 mg in adults) if pt to be admitted
- Orapred 2 mg/kg/day X 3 days if stable for discharge
- Observation for 4-6 hrs from epi dose for recurrence of symptoms.
- Bolus with Normal Saline if hypotensive or may need to start epinephrine drip.