Contrast medium reaction

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30px This page in a nutshell: Adrenaline, 0.3-0.5mg in adults, given intramuscularly, is the most important initial therapy. Peripheral venous catheter and IV fluids are needed for everyone with anaphylaxis. Oxygen saturation, pulse and blood pressure are monitored.

In case of a contrast medium reaction, a patient should be evaluated for the presence of the following symptoms and be medicated accordingly. Anaphylaxis is a more severe allergic reaction whose diagnostic criteria generally include low blood pressure and/or respiratory distress, and indicate the attention of an anesthesiologist or corresponding clinician on duty.

Symptoms	Medication	Route	Dosage		Time to effect	Repeat
			Adults	Children
Severe hives LRespiratory distress Hypotension Altered level of consciousness Severe abdominal pains and vomiting	Injection of adrenaline	Intramuscular in lateral thigh	0.3 - 0.5 mg	0.01 mg/kg, up to 0.5 mg 10-20kg: 0.15 mg ≥20kg: 0.3 mg	Less than 5 min	Every 5-10 min if needed
Asthma	Salbutamol (Ventolin) or own bronchodilator	Inhalation	5 mg Usually 4-6 doses	2-6 doses	Less than 5 min	Every 10 mins if needed
Hypoxia	Oxygen	Mask	>5 l/min		Almost immediate	Continuous
Altered level of consciousness or hypotension	Volume expander such as Ringer's	IV with pressure	20mg/kg		Fast	As needed
All anaphylaxis cases	Antihistamine such as desloratadine (Clarinex/Aerius)	Oral	10mg of desloratadine	<6 years: 2.5mg desloratadine 6 - 12 years: 5 mg desloratadine	Within 30-60 minutes	Usually not
All anaphylaxis cases	Glucocorticoid such as betamethasone	Oral or IV	5-8 mg betamethasone	<6 years: 3-4 mg ≥6 years: 5-8 mg	2-3 hours	Usually not