Refractory Anaphylaxis
May 13, 2024![](https://kajabi-storefronts-production.kajabi-cdn.com/kajabi-storefronts-production/file-uploads/blogs/2147545446/images/3db12bc-581-ea8f-b21c-734736ebad7c_5-7.png)
Anaphylaxis will respond to standard management in 95% of cases. For the other 5%, your team needs a plan. The ANZAAG Anaphylaxis Management Guidelines have a card for this scenario. Here is an outline of what’s involved: ππΌππ
1οΈβ£ Request more help
π Consider pressing the emergency bell or requesting experienced assistance
2οΈβ£ Triggers
π Check again if there are any possible triggers still being administered. These may include latex, chlorhexidine or synthetic colloids.
3οΈβ£ Monitoring
π Consider placing an arterial line
π Consider the use of echocardiography (TTE/TOE)
4οΈβ£ For resistant hypotension
π Additional 50ml/kg bolus of crystalloid
π Noradrenaline infusion
π Vasopressin bolus and infusion
π Glucagon bolus (for beta blocker reversal)
π Remember to ensure manual left uterine displacement in pregnant patients
5οΈβ£ For resistant bronchospasm
π Rule out oesophageal intubation, circuit malfunction, tension pneumothorax
π Continue adrenaline infusion
π Add bronchodilators
πΊ Salbutamol
πΊ Magnesium
πΊ Volatiles
πΊ Ketamine
6οΈβ£ Consider other diagnoses!
Build knowledge β
Improve safety β
Ref: https://anzaag.com/anaphylaxis-management/management-resources/