›Immediate stabilization workflow
›Airway positioning and suction readiness
›Continuous pulse oximetry
›Cardiac monitor
›Two IV lines if airway risk or anaphylaxis concern
›Oxygen if SpO2 less than 94 percent
›Early airway team activation triggers
›Voice change
›Stridor
›Drooling
›Rapid tongue progression
›Airway management principles
›Early decision making before progression
›Awake fiberoptic intubation consideration with anticipated difficult airway
›Surgical airway equipment readiness
›Avoid repeated traumatic attempts
Histamine mediated treatment
›Allergic pathway treatment
›Epinephrine IM 0.3 mg of 1 mg per mL for anaphylaxis concern
›Repeat IM every 5 to 15 minutes if ongoing anaphylaxis physiology
›Cetirizine PO 10 mg if able to swallow and non severe
›Diphenhydramine IV 25 mg to 50 mg as adjunct if severe symptoms
›Famotidine IV 20 mg as adjunct
›Dexamethasone IV 10 mg or methylprednisolone IV 125 mg adjunct
›Nebulized epinephrine as bridge for upper airway symptoms local protocol dependent
Bradykinin mediated treatment
›Bradykinin pathway treatment
›Immediate discontinuation of ACE inhibitor
›C1 inhibitor concentrate dosing per product and protocol
›Icatibant dosing per product and protocol
›Fresh frozen plasma 2 units if specific agents unavailable local protocol dependent
›Tranexamic acid dosing local protocol dependent
›Team involvement
›Anesthesia for anticipated difficult airway
›ENT for laryngoscopy and airway planning
›ICU for high risk airway or hemodynamic instability
›Allergy immunology follow up for recurrent or unclear mechanism
Monitoring and reassessment loop
›Reassessment cadence
›Airway symptom check every 15 to 30 minutes early course
›Repeat focused oral exam for tongue and floor of mouth progression
›Repeat vitals after epinephrine administration
›Escalate level of care if any progression