ED Clinical Pathway for Evaluation/Treatment of Children with Anaphylaxis

Key Components of MD/CRNP/RN Assessment


CC: "Having an allergic reaction"

  1. Visual assessment of child's distress.
  2. Chest exam and adequacy of perfusion.
  3. Vital signs and pulse oximetry on all patients.
  4. Identify:
    • Duration of symptoms
    • Possible trigger
    • Known allergy, review medical alert bracelet
    • Current medications (prescription, OTC)
    • Epipen used? When?




Review triage information:

  1. Assessment of respiratory/cardiovascular status.
  2. If Critical/Acute – place CR monitor, continuous pulse oximetry, BP q 15 minutes
  3. Identify/confirm:
    • Epipen dose/s
    • Other medications given, doses and time
    • Previous anaphylactic / allergic reactions
  4. Contact MD/CRNP for initial assessment, treatment
  5. Prepare for administration of IM epinephrine (1:1000)
  6. Page respiratory to administer neb if patient is stridorous, wheezing