<b>General measures<b><br>-Determine and remove the cause -Secure the airways -Restore BP: lay the patient flat and raise feet -Keep patient warm -<b>Sodium chloride</b> 0.9% infusion 20 ml/kg by IV infusion over 60 minutes –– Start rapidly then adjust rate according to BP -Administer oxygen. <br><b>Adrenaline (epinephrine)</b><br>injection 1 in 1000 (1 mg/ml) 0.5 mg (0.5 ml) IM immediately, into anterolateral thigh –– Repeat every 5-10 minutes according to BP, pulse rate, and respiratory function until better Child <6 years: 150 micrograms (0.15 ml) Child 6-12 years: 300 micrograms (0.3 ml)<br><b>In severely affected patients</b><br><b>Hydrocortisone</b> 200 mg IM or slow IV stat Child <1 year: 25 mg Child 1-5 years: 50 mg Child 6-12 years: 100 mg<br><b>If urticaria/itching</b><br>ffGive an antihistamine as useful adjunctive treatment e.g. chlorpheniramine 4 mg ever 6 hours Child 1-2 years: 1mg every 12 hours Child 2-5 years: 1 mg every 6 hours Child 5-12 years: 2 mg every 6 hours –– or promethazine 25-50 mg by deep IM or very slow IV (or oral) Child 1-5 years: 5 mg by deep IM Child 5-10 years: 6.25-12.5 mg by deep IM –– Repeat dose every 8 hours for 24-48 hours to prevent relapse ffRepeat adrenaline and hydrocortisone every 2-6 hours prn depending on the patient’s progress