Table 4

First line treatment of anaphylaxis12 28 60 61

DrugRecommended doseComment
Intramuscular epinephrine (0.01 mg/kg of 1:1000)

  • Adult: 0.5 ml

  • >12 years: 0.5 ml (0.3 ml if small or pre-pubertal)

  • >6–12 years: 0.3 ml

  • <6 years: 0.15 ml

Repeat every 5–15 min
OxygenHighest possible concentration6–8 l/min (WAO)
Intravenous fluids (intra-osseous route possible)

  • 0.9% NaCl

  • Hartmann's solution

  • Correct hypovolaemia (NaCl remains in intravascular space longer than glucose and contains no lactate)

  • 1–2 litres usually needed in first 5 min (adult); children 30 mg/kg in the first hour

  • Anaphylaxis to colloids described

  • WAO, World Allergy Organisation.