Moderate to Severe Allergic Reaction Medical Directive

Question 1

Moderate to Severe Allergic Reaction Medical Directive

Answer 1

A Primary Care Paramedic may provide the treatment prescribed in this Medical Directive if authorized

Question 2

Indications

Answer 2

Exposure to a probable allergen;
AND
Signs and/or symptoms of a moderate to severe allergic reaction (including anaphylaxis).

Question 3

Conditions - Epinephrine

Answer 3

Age: N/A
Weight: N/A
LOA: N/A
HR: N/A
RR: N/A
SBP: N/A
Other: For anaphylaxis only

Question 4

Conditions - Diphenhydramine

Answer 4

Age: N/A
Weight: ≥ 25 kg
LOA: N/A
HR: N/A
RR: N/A
SBP: N/A
Other: N/A

Question 5

Contraindications - Epinephrine

Answer 5

Allergy or sensitivity to epinephrine

Question 6

Contraindications - Diphenhydramine

Answer 6

Allergy or sensitivity to diphenhydramine.

Question 7

Treatment

Answer 7

• Consider epinephrine

- Consider diphenhydramine

Question 8

Consider epinephrine

Answer 8

Route: IM
Concentration: 1 mg/mL = 1:1,000
Dose: 0.01 mg/kg*
Max. single dose: 0.5 mg
Dosing interval: Minimum 5 min
Max. # of doses: 2
*The epinephrine dose may be rounded to the nearest 0.05 mg

Question 9

Consider diphenhydramine

Answer 9

Weight ≥25 kg to <50 kg
Route: IV/IM
Dose: 25 mg
Max. Single dose: 25 mg
Dosing interval: N/A
Max. # of doses: 1

Weight ≥50 kg
Route: IV/IM
Dose: 50 mg
Max. single dose: 50 mg
Dosing interval: N/A
Max. # of doses: 1

Question 10

Clinical Considerations

Answer 10

Epinephrine administration takes priority over IV access.

IV administration of diphenhydramine applies only to PCPs authorized for PCP autonomous IV.