Reply To: Anaphylaxis

  • Lyndzie West

    May 16, 2023 at 5:02 pm
    Good afternoon! My name is Lyndzie Legg. At our outpatient clinic here is what we do for anaphylactic medications. 

    1. For duration of stay after mediation infusion- we utilize that for Pegaspargase, CAL-PEG, Rylaze, and Iron. Sometimes medications that are research require that as well. For Peg products, along with Rylaze, they stay for 1 hour post administration with vital signs. For Iron, the patient will stay for 30 minutes post administration with vital signs. All lines and anaphylactic kits/products are left at bedside until discharge. 
    2. For cases of reaction- we keep them on continuous pulse ox, and gather other vitals cycling at q10-15 then to 30 minutes depending on symptoms. If the patient receives Epinephrine, they are on continuous pulse ox, VS q10-15 for one hour at least or until symptoms have resolved. They will stay for 6hrs post epinephrine. If Benadryl is given, we have them stay for at least an hour or until symptoms have resolved and hemodynamically stable. 
    Of course, severity of the case will require more or less interventions, but this is what we maintain at baseline. 
    Lyndzie Legg BSN, RN, CPHON
    Texas Children’s Hospital 
    Hematology-Oncology & Infusion Center 

    Original Message:
    Sent: 5/16/2023 4:47:00 PM
    From: Elissa Shulta
    Subject: Anaphylaxis

    Hi, All-

    I’m curious what your current practice is with meds that have a risk for anaphylaxis:

    1. when a med that has a risk for anaphylaxis is given, how long do you make the patient stay for observation/monitoring after the infusion is complete?

    2. If a patient ends up having an anaphylactic reaction, what does your vital sign frequency change to? How long is the observation time if Epi is given? How long is the observation time if Benadryl is given?

    Thanks in advance!

    Elissa Shulta, DNP,RN,CPHON
    Clinical Nurse Specialist
    Children’s Wisconsin
    Milwaukee, WI
    United States