Evidence-based On-call

Anaphylaxis

Therapy

Give IM adrenaline (SC if necessary) ^a

Why?

96% of patients with circulatory collapse responded to adrenaline (95% CI: 93% to 100%). ^a
Intravenous adrenaline has been associated with arrhythmias. ^d

Note:

Adrenaline given subcutaneously took longer to reach peak levels compared with intramuscularly

Patients	Outcome	Treatment	Control group (SD)	Experimental group (SD)	Mean difference (95% CI)
children with history of anaphylaxis ^c	minutes to peak adrenaline levels	IM (exp) vs SC (ctl) adrenaline	34 (40)	8 (6)	26 (-3 to 55)