exceptions, follow-up evaluation should take place within a day to a week of the ED visit Suggested Readings and Key References Balekian DS, Linnemann RW, Hasegawa K, et al Cohort study of severe bronchiolitis during infancy and risk of asthma by age years J Allergy Clin Immunol Pract 2017;5(1):92–96 Bradley JS, Byington CL, Shah SS, et al The management of communityacquired pneumonia in infants and children older than months of age: clinical practice guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America Clin Infect Dis 2011;53(7):e25–e76 Ducharme FM, Tse SM, Chauhan B Diagnosis, management, and prognosis of preschool wheeze Lancet 2014;383:1593–1604 Martinati LC, Boner AL Clinical diagnosis of wheezing in early childhood Allergy 1995;50:701–710 Nagler J, Krauss B Capnographic monitoring in respiratory emergencies Clin Ped Emerg Med 2009;10:82–89 Ralston SL, Lieberthal AS, Meissner HC, et al Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis Pediatrics 2014;134(5):e1474–e1502 Shah SN, Bachur RG, Simel DL, et al Does this child have pneumonia?: the rational clinical examination systematic review JAMA 2017;318(5):462–471 Taussig LM, Wright AL, Holberg CJ, et al Tucson children’s respiratory study: 1980 to present J Allergy Clin Immunol 2003;111(4):661–675 The Children’s Hospital of Philadelphia Clinical Pathways ED Pathway for Evaluation/Treatment of Children With Asthma URL: https://www.chop.edu/clinical-pathway/asthma-emergent-careclinical-pathway Authors: J Zorc; R Scarfone; A Reardon, CRNP; N Stroebel, CRNP; W Frankenberger, RN; L Tyler, RT; D Simpkins, RT; R Abaya, MD; E Delgado, MD; E Brill, RN Posted: October 2005, last revised March 2020 ED Pathway for Evaluation/Treatment of Children With Bronchiolitis URL: https://www.chop.edu/clinical-pathway/bronchiolitis-emergentevaluation-clinical-pathway Authors: R Abaya, MD; K Crescenzo, RN; E Delgado, MD; M Dunn, MD; M Kerrigan, RRT; N Muthu, MD; C Nelson, MD; A Reardon, CRNP; B Rodio, RN; N Strobel, CRNP; D Simpkins, RRT; L Tyler, RRT; J Zorc, MD Posted: September 2005, last revised December 2019 SECTION IV Medical Emergencies CHAPTER 85 ■ ALLERGIC EMERGENCIES TIMOTHY E DRIBIN, RICHARD M RUDDY GOALS OF EMERGENCY THERAPY Treatment of anaphylaxis with rapid administration of intramuscular (IM) epinephrine is imperative to prevent and reverse cardiopulmonary failure Treatment of hereditary angioedema includes rapid, controlled airway management in cases with significant laryngeal edema and prompt administration of C1-esterase inhibitor concentrate (or alternative therapy) to reduce complications from acute attacks Management of serum sickness includes removing offending antigens, controlling symptoms (arthralgias and pruritis) with nonsteroidal antiinflammatory drugs (NSAIDs) and antihistamines, and screening for organ dysfunction (particularly renal involvement) Intranasal corticosteroids are considered the first-line treatment for allergic rhinitis Oral nonsedating antihistamines and montelukast are common alternative therapies RELATED CHAPTERS Signs and Symptoms Edema: Chapter 25 Eye: Red Eye: Chapter 27 Rash: Papulosquamous Eruptions and Viral Exanthems: Chapter 70 Sore Throat: Chapter 74 Stridor: Chapter 75 Wheezing: Chapter 84 Medical Emergencies Dermatologic Urgencies and Emergencies: Chapter 88 Pulmonary Emergencies: Chapter 99 The Children’s Hospital of Philadelphia Clinical Pathway ... Medical Emergencies CHAPTER 85 ■ ALLERGIC EMERGENCIES TIMOTHY E DRIBIN, RICHARD M RUDDY GOALS OF EMERGENCY THERAPY Treatment of anaphylaxis with rapid administration of intramuscular (IM) epinephrine