Allergic Reaction

'' These observation periods are often short, but important in watching for airway compromise "

Transfer Criteria

  • Response to therapy in the ED
  • Erythroderma, urticaria, or angioedema not involving airway
  • Minimum 2-hours of stability or improvement in ED after treatment

Exclusion Criteria

  • Hypotension (SBP <100), tachycardia > 110
  • O2 saturation consistently < 94% on room air
  • Suspicion of acute coronary syndrome
  • Stridor, respiratory distress, hoarseness
  • IV pressors required

Potential Interventions

  • IV fluids as needed
  • Frequent rechecks and documentation of clear airway
  • Antihistamines, corticosteroids
  • Cardiac monitoring (if indicated)
  • Inhaler or nebulizer treatments (if indicated)
  • Pulse oximetry
  • Repeat doses of SQ epinephrine

Discharge Criteria


    • Resolution or improvement in clinical condition
    • Stable VS


    • Delayed worsening
    • Persistent wheezing or stridor
    • Inadequate response to therapy during observation
    • Inability to take po medications
    • Abnormal vital signs: SBP < 100mm or RR > 24/min or hypoxia


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