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http://mastcelldisorders.wallack.us/yabb/YaBB.pl Emergency Protocols and Information >> Emergency Protocols and Information >> Dr. Castells' Emergency Protocols http://mastcelldisorders.wallack.us/yabb/YaBB.pl?num=1293573404 Message started by Lisa on 12/28/10 at 09:56:44

Title: Dr. Castells' Emergency Protocols
Post by Lisa on 12/28/10 at 09:56:44

( Archived from original forum - deborahw)

(This is the information linked to by Michelle from mastopedia.com in another thread on our forum. It originates from the TMS website at http://www.tmsforacure.org/documents/castells_emergencyplan.pdf and is a generalized guide written by Dr. Castells that should be modified by your personal doctor to match your particular health condition.)

[b]MEDICAL EMERGENCY RESPONSE PLAN FOR:
SYSTEMIC MASTOCYTOSIS, MAST CELL ACTIVATION DISORDER AND ANAPHYLAXIS[/b]

If the patient presents with flushing, rash, hives, swelling, abdominal pain, nausea, vomiting, shortness of breath, wheezing or hypotension, respond with the following:

Administer

• Epinephrine 0.3 cc of 1/1000 and repeat 3x at 5-minute intervals if BP < 90 systolic (0.1 cc for children under 12)

• Benadryl (Generic: diphenhydramine) 25-50 mg (12.5-25 for children under 12) orally, intramuscular or intravenously every 2—4 hours or Atarax (Generic: hydroxizine) 25mg (12.5 mg for children under 12) orally every 2—4 hours

• Solu-Medrol (Generic: methylprednisolone) 120 mg (40 mg for children under 12) IV/IM

• Oxygen by mask or nasal canula 100%

• Albuterol nebulization

Call 911 and take the patient to the closest Emergency Room.

[b]Pre-medication for major and minor procedures and for radiology procedures with and without dyes:[/b]

• Prednisone 50 mg orally (20 mg for children under 12) 24 hours and 1—2 hours prior to surgery

• Benadry1 (Generic: diphenhydramine) 25-50 mg orally (12.5 mg for children under 12) or Atarax (Generic: hydroxizine) 25 mg orally, 1 hour prior to surgery

• Zantac (Generic: ranitidine) 150 mg orally (20 mg for children under 12) 1 hour prior to surgery

• Singulair (Generic: montelukast) 10 mg orally (5 mg for children under 12) 1 hour prior to surgery

Drugs to be avoided:

• Aspirin and non-steroidal anti-inflammatory medications

• Morphine, codeine derivatives

• Vancomycin

Recommended Drugs:

• Tylenol