akflightmedic Posted January 27, 2009 Share Posted January 27, 2009 As an aside...what's up with you guy's quote functions. Why does it not seem to work EVER for a few of you? As for the topic, it has been well known for years that some people are allergic to the dye in Benadryl, hence if you look at the shelves you will see "dye free" options. As Crochity said, it is not a trick, it isn't about what caused it, he has told us that. He is asking for different treatment options not the zebra amongst the horses. From my perspective, the kid is going to get the following: Epi IM Aggressive airway tactics (RSI or PAI), we can not wait to see if the epi reverses the problem, we do not have that time. If you wait, you will have a kid impossible to intubate and then will be forced to do a cric. Neb treatments via ETT if needed Once IV is established, solumedrol or decadron will be given. Tagamet IV Dye free benadryl IV I think that will cover him. Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted January 27, 2009 Share Posted January 27, 2009 as an aside again, I hit the quote button and that is what you got. Do you have any idea why quotes work for some while they do not work for others? Maybe this is a question for Admin instead. As for the allergy and zebra in the room. I've been doing this for a very long time and I've seen only a couple allergies to benadryl and I do not believe that any of those allergies were truly to benadryl but more based on the allergy to the dye. I'm not saying that the kiddo isn't allergic to the benadryl itself because he very well may be but... I'd be more inclined to believe it was something in the benadryl liquid rather than benadryl. But that's just my thoughts. but as for treatment - My treatment isn't going to differ from your treatment AK. Link to comment Share on other sites More sharing options...
crotchitymedic1986 Posted January 27, 2009 Author Share Posted January 27, 2009 Very good input from all. The reason I posted this scenario is that there is disagreement over whether or not you can be allergic to an antihistamine. Some believe: 1. You can not be allergic. 2. The allergy is to the dye in the liquid benadryl 3. You can be allergic to benadryl. If you google "allergic to benadryl" you will find several internet posts from people who have sufferred some kind of reaction. Obviously, some people are confused as to what an "allergic reaction" is versus a side effect, but the more I read, the more I became convinced that some people could be allergic to Benadryl (with or without dye). So what are your thoughts, can you be allergic ? If so, do you dare give benadryl again if you know the patient took benadryl with a dye in it ? Or do you just go straight to dopamine if the steroids and epi dont work ? Link to comment Share on other sites More sharing options...
iMac Posted January 27, 2009 Share Posted January 27, 2009 From an ALS point of view, High Flow 02, Epi 0.01mg/kg. Mild reactions go to Diphenhydramine 1mg/kg. The most severe cases goes down to treating for shock (and/or bronchospams, hypotension etc) I would have to see what other drugs might come into affect, need to go thru the binder. Link to comment Share on other sites More sharing options...
Dustdevil Posted January 27, 2009 Share Posted January 27, 2009 Did I miss something? What "cream" do you keep referring to?? I read it as the child ingesting LIQUID Benadryl. LOL! Gotta wonder how many parents rub liquid Benadryl all over their kids! You KNOW it happens! Link to comment Share on other sites More sharing options...
Mateo_1387 Posted January 27, 2009 Share Posted January 27, 2009 Neb treatments via ETT if needed Once IV is established, solumedrol or decadron will be given. Tagamet IV Dye free benadryl IV I think that will cover him. Phenergan could also be used as an H1 histamine blocker. Link to comment Share on other sites More sharing options...
akflightmedic Posted January 27, 2009 Share Posted January 27, 2009 You are correct Mateo. A little factoid for you, in several other countries, Phenergan is used as a histamine blocker primarily. Some of my Aussie coworkers had never heard of it being used for Nausea/Vomiting (they were shocked really), they thought I was joking when I told them most services stateside only use it for that reason and most medics would have no clue it could be used for allergic reactions...LOL. Link to comment Share on other sites More sharing options...
spenac Posted January 27, 2009 Share Posted January 27, 2009 You are correct Mateo. A little factoid for you, in several other countries, Phenergan is used as a histamine blocker primarily. Some of my Aussie coworkers had never heard of it being used for Nausea/Vomiting (they were shocked really), they thought I was joking when I told them most services stateside only use it for that reason and most medics would have no clue it could be used for allergic reactions...LOL. LOL. I forgot to include it though we also do include it for allergic reactions. My bad. Education is ruining my skills. :wink: Link to comment Share on other sites More sharing options...
Jeepluv77 Posted March 8, 2009 Share Posted March 8, 2009 You are correct Mateo. A little factoid for you, in several other countries, Phenergan is used as a histamine blocker primarily. Some of my Aussie coworkers had never heard of it being used for Nausea/Vomiting (they were shocked really), they thought I was joking when I told them most services stateside only use it for that reason and most medics would have no clue it could be used for allergic reactions...LOL. I had no clue it could be used for allergic reactions. Why isn't it used for that more often here? As for whether you can be allergic to the actual drug: I don't know if the chemical(s)/proteins in it are naturally found in the body, but if they aren't then I would imagine you could be allergic to it. If so, then I would be interested to find out if maybe it's an abnormal type of allergic reaction, if that's even possible. Does anyone know if there have been any in-depth studies into it? Link to comment Share on other sites More sharing options...
FireMedic65 Posted March 8, 2009 Share Posted March 8, 2009 It is to my understanding that phenergan isn't recommended to give in allergic reactions IV/IM/SQ, only PO. Have I been misinformed here? If I am correct, then in this scenario, giving pheneran to this child might not work very well if his throat is swelling. Ok, sorry... my mistake. It can be used in IV or IM at the same dose you would for PO. Link to comment Share on other sites More sharing options...
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