ACS Sepsis Stroke Trauma GI bleed DKA Anaphylaxis Pregnancy trauma Child sepsis Status epilepticus APO HyperK

Anaphylaxis

Start this sheet when: Sudden airway (swelling, stridor, hoarse voice), breathing (wheeze, falling SpO2) or circulation (low BP, collapse) problem after a likely trigger, usually with skin or lip changes. A reaction inside the ED: enter the reaction time as the door time.

Hospital (remembered on this device)Patient ID / UHID (not saved)Age / SexFilled by

Door dateDoor time (clock starts here)

Onset of reaction (clock time)

Time since door

Targets met --Breaches 0

1.IM adrenaline 0.5 mg (1 mg/mL) in the outer thigh
≤ 5 min from door · RC UK: the moment it is recognised
Enter door time
2.Second IM adrenaline dose(No improvement)
≤ 5 min from first adrenaline · RC UK: repeat after 5 min if no better
N/AEnter door time
3.IV access and fluid bolus (500-1000 mL) running(Low BP or shock)
≤ 15 min from door · Local target: with the second dose
N/AEnter door time
4.Low-dose IV adrenaline infusion started(Refractory)
≤ 15 min from second adrenaline · RC UK: refractory after two IM doses
N/AEnter door time
5.Mast cell tryptase, first sample
≤ 1 h from door · RC UK: once treatment is under way
Enter door time
6.Mast cell tryptase, second sample
≤ 2 h from onset of reaction · RC UK: 1-2 h after onset, never after 4 h
Enter door time
7.Symptoms resolved
Record · Observation clock starts here
Enter door time
8.Disposition decided
Record · Admit / transfer / OT; for the length-of-stay audit
Enter door time
9.Patient left the ED
≤ 2 h from disposition decision · ED KPI: decision to departure 2 h or less
Enter door time

Bedside checklist

☐Adrenaline dose: 12 yr+ 0.5 mg, 6-12 yr 0.3 mg, under 6 yr 0.15 mg IM
☐Stop the trigger: drug infusion, blood, contrast
☐Lie flat with legs up; sit up if breathless; left side if pregnant
☐Antihistamine and steroid never replace or delay adrenaline
☐On a beta-blocker and not responding: glucagon 1-2 mg IV
☐Observe 6 h after resolution; 12 h if severe or 2+ doses needed
☐Home with 2 auto-injectors, or taught to draw 0.5 mL from an ampoule
☐Trigger written on the discharge slip and allergy clinic referral

References

Targets marked “local” are suggestions: agree your own with the quality committee before auditing against them.

Bedside checklist

☐Adrenaline dose: 12 yr+ 0.5 mg, 6-12 yr 0.3 mg, under 6 yr 0.15 mg IM

☐Stop the trigger: drug infusion, blood, contrast

☐Lie flat with legs up; sit up if breathless; left side if pregnant

☐Antihistamine and steroid never replace or delay adrenaline

☐On a beta-blocker and not responding: glucagon 1-2 mg IV

☐Observe 6 h after resolution; 12 h if severe or 2+ doses needed

☐Home with 2 auto-injectors, or taught to draw 0.5 mL from an ampoule

☐Trigger written on the discharge slip and allergy clinic referral