Anaphylactic Shock — Uganda (General Pediatric population)
Volume Resuscitation
Sodium chloride 0.9% infusion 20 ml/kg IV over 60 minutes. Start rapidly then adjust according to BP.
Adrenaline — Child < 6 years
Adrenaline (epinephrine) 1 in 1,000: 150 micrograms (0.15 ml) IM into anterolateral thigh. Repeat every 5–10 minutes according to BP, pulse, and respiratory function until better.
Adrenaline — Child 6–12 years
Adrenaline (epinephrine) 1 in 1,000: 300 micrograms (0.3 ml) IM into anterolateral thigh. Repeat every 5–10 minutes as needed.
Hydrocortisone — Child < 1 year
Hydrocortisone 25 mg IM or slow IV stat. Repeat every 2–6 hours as needed.
Hydrocortisone — Child 1–5 years
Hydrocortisone 50 mg IM or slow IV stat.
Hydrocortisone — Child 6–12 years
Hydrocortisone 100 mg IM or slow IV stat.
Antihistamine — Child 1–2 years
Chlorpheniramine 1 mg every 12 hours. OR Cetirizine 2.5 mg once daily.
Antihistamine — Child 2–5 years
Chlorpheniramine 1 mg every 6 hours.
Antihistamine — Child 5–12 years
Chlorpheniramine 2 mg every 6 hours. OR Cetirizine 5 mg daily (≥6 years). OR Promethazine 6.25–12.5 mg by deep IM. Repeat every 8 hours for 24–48 hours.
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