Anaphylaxis Crash Cart

In addition to the recommended routine supplies, every practice that intends to perform allergen immunotherapy must be supplied and trained for possible severe systemic reactions, such as anaphylaxis. Below is a list of recommended emergency supplies that should be stocked separately from the routine supplies. Modifications may be necessary depending on the anticipated response time of emergency personnel and the staff’s airway management skills. These supplies should be stored in an easily accessible location, such as a crash cart. As these are used, they will need to be replaced. Procedures should be established to routinely check all supplies for expiration and restocking. Regular drills should also be performed to ensure staff readiness in the event of an emergency.

1.  Stethoscope and Sphygmomanometer
2. Tourniquets
3. Syringes
4. IV Catheters (e.g. 14-18 gauge)
5. Aqueous Epinephrine HCL (1:1000 w/v) or equivalent (e.g. Epi-Pen)
6. Airway support devices (e.g. endotracheal tubes, resuscitator bag)
7. Portable oxygen supply
8. Oral and injectable antihistamines (both H1 and H2)
9. Corticosteroids for intramuscular or intravenous injection
10. Ammonia inhalant pad or breakable capsule
11. IV Fluids (e.g. saline)
12. Glucagon kit for patients on β-blockers

For more detail about the treatment of anaphylaxis and the equipment required, see: Lieberman P, Nicklas RA, Oppenheimer J, et al. The diagnosis and management of anaphylaxis practice parameter: 2010 update. J Allergy Clin Immunol 2010;126:477-80, e1-42. If you encounter a systemic reaction, please contact your allergen extract supplier for assistance.