Anaphylaxis
Paediatric emergency management · Airway/Circulation · Emergency
Recognise: acute onset of airway/breathing/circulation compromise with skin or GI features after a likely trigger. Remove the trigger and call for help.
Immediate
Adrenaline IM (1:1000)0.01 mg/kg IM anterolateral thigh, repeat every 5 min as neededMaximum 0.5 mg
- High-flow oxygen; position supine with legs raised (sit up if respiratory distress).
- IV/IO access; isotonic fluid bolus 10–20 mL/kg for hypotension, repeat as needed.
- Nebulised salbutamol for bronchospasm; nebulised adrenaline for stridor.
Refractory
- Start an adrenaline infusion (0.05–0.3 mcg/kg/min) if repeated IM doses fail.
- Consider glucagon if on beta-blockers.
Common questions
What is the first step in anaphylaxis?
Recognise: acute onset of airway/breathing/circulation compromise with skin or GI features after a likely trigger. Remove the trigger and call for help.
What drug doses are used in anaphylaxis?
Adrenaline IM (1:1000): 0.01 mg/kg IM anterolateral thigh, repeat every 5 min as needed.
About this page
Compiled from standard paediatric references. Verify against a current formulary and your local protocol.
Spotted something wrong? Report an error on this page — corrections from clinicians are welcome and are reviewed before any change is published.
Last reviewed 2026-08-12.