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Fluid infusion: 1-2L (20mL/kg) as a bolus if there is evidence of shock. 5-5mg for children aged 1-6yrs. g. salbutamol • Provide with self-administered adrenaline/epinephrine syringes (EpiPen or EpiPen Junior). 3mL of 1 in 2,000 solution (150mcg) for children. uk) or a wallet card • Serum sample for mast cell tryptase may be useful in obscure anaphylactic reactions to confirm the diagnosis retrospectively; this is an investigation only available in tertiary referral centres. Ten mL of clotted blood is sent to the reference laboratory.
Amiodarone • 150mg diluted in 5% dextrose to a volume of 20mL over 10min; a further 150mg may be given • or 300mg (5mg/kg) in 250ml 5% dextrose over 1hour, followed by 900mg (15mg/kg) over 24h. Digoxin • 500mcg in 50mL 5% dextrose over 30min IV; depending on response, up to a further 500mcg can be given in two divided doses of 250mcg. Lidocaine • 50mg IV; repeat every 5min to a maximum of 200mg. Verapamil 5-10mg over 2min IV; repeat 5mg 5min later if necessary Flecainide 100-150mg (2mg/kg) over 30min IV.
Predictors of difficult bag and mask ventilation • Excessive facial hair (beards) • Obesity • Advanced age • Snoring. To improve mask seal: • Apply water-soluble lubricant to the facial hair in the presence of beards and moustaches • Replace dentures in edentulous patients • Fluff and compress gauze sponges (4 Ã 4) and insert into the cheeks to create an improved mask seal. There is, however, a potential for losing or causing airway obstruction. 113 63 64 Fig. 6 Bag and face mask. 114 Adult and paediatric choking Mild obstruction, with the preservation of the ability to breathe, speak and cough: encourage continued coughing only.
A Resuscitation Room Guide Banerjee by Hargreaves