Moderate to Severe Allergic Reaction Medical Directive

Question 1

Allergic

What are the indications for the Moderate to Severe Allergic Reaction Medical Directive?

Answer 1

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

Question 2

Allergic

What are the conditions for epinephrine administration?

Answer 2

Other: For anaphylaxis only.

Question 3

Allergic

What are the conditions for dyphenhydramine administration?

Answer 3

Weight ≥25 kg

Question 4

Allergic

What are the contraindications to epi administration?

Answer 4

Allergy or sensitivity to
EPINEPHrine

Question 5

Allergic

What are the contraindications to diphenhydramine administration?

Answer 5

Allergy or sensitivity to
diphenhydramine.

Question 6

Allergic

What is the dose for epi administration?

Answer 6

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 7

Allergic

What is the dose of dyphenhydramine for patients who are Weight ≥25 kg to <50 kg?

Answer 7

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

Question 8

Allergic

What is the dose of dyphenhydramine for patients who are ≥50 kg?

Answer 8

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

Question 9

Allergic

What are the clinical considerations for the Moderate to Severe Allergic Reaction Medical Directive?

Answer 9

• EPINEPHrine administration takes priority over IV access.
• IV administration of diphenhydrAMINE applies only to PCPs authorized for PCP Autonomous IV.