In emergency pediatrics, anaphylaxis is, fortunately, very rare. When it
occurs, the cause is usually an insect sting.
c. Treatment for Anaphylaxis.
(1) Administer aqueous epinephrine in the dosage 1:1000, 0.1 to 0.3 ml
subcutaneously. The dosage may be repeated in 15 minutes.
(2) Apply a tourniquet above the injection site of antigen or the inoculation
site if the injury is a bit or a sting. An assistant should inject 0.2 ml of aqueous
epinephrine in the dosage 1:1000 around the antigen injection site or sting.
(3) Quickly begin administering normal saline intravenously to support blood
pressure and treat hypovolemia.
(4) Arrange for the monitoring of blood pressure and an electrocardiogram
for cardiovascular complications.
(5) Maintain a patent airway. View the uvula and pharynx frequently,
checking for evidence of swelling.
3-10. CROUP (LARYNGOTRACHEOBRONCHITIS)
Croup is a common viral, sometimes bacterial, infection which occurs in a child's
upper airways. Children between six months and four years experience this illness.
The condition is rarely seen in older children.
a. Signs/Symptoms of Croup. A child who has croup has usually just had a
cold or other infection. Signs and symptoms of croup include the following.
Airway obstruction caused by edema (swelling of tissues).
Hoarse voice with high-pitched sounds.
A whooping sound when the child breathes in.
(4) Avoidance of lying down. The child breathes easier in an upright
position than when he is lying down. Therefore, he resists efforts of adults to make him
(5) As edema in the airway increases, the child's use of his accessory
muscles of respiration causes the following:
(a) Nasal flaring.