Paramedic Kardex
The is a quick reference ONLY to the Policies and Guidelines set by OCEMSA.
All specific Treatment Guidelines questions should be directed to the OCEMSA Website.
PEDS
Allergic Reaction or Anaphylaxis
Algorithm
Allergic Reaction: Mild (rash, urticaria, stable vital signs):
→ Pulse oximetry, if SPO2 less than 95%
▼
High flow oxygen by mask as tolerated
Allergic Reaction: Moderate (facial/cervical angio-edema, SOB or wheezing):
→ Pulse oximetry, if oxygen saturation less than 95%
►High flow oxygen by mask as tolerated
▼
►Epinephrine 0.01 mg/kg IM (1 mg/mL) (maximum 0.3 mg)
►Diphenhydramine: 1 mg/kg IM / IV (maximum 50 mg), may repeat once in 3 min
→ If wheezing present:
►Albuterol: 5 mg (6 mL) nebulize continuous as tolerated
Anaphylaxis: Severe (hypotension, severe wheezing, SOB, impending airway obstruction):
→ Pulse oximetry, if oxygen saturation less than 95%
► High flow oxygen by mask as tolerated
▼
Epinephrine IV preferred if established, if not use Epinephrine IM
►Epinephrine 0.01 mg/kg IM (1 mg/mL) (maximum 0.3mg)
or
►Epinephrine 0.01 mg/kg slow IV/ IO (0.1 mg/mL) (IV access is preferred, max 0.3 mg)
▼
►Diphenhydramine: 1 mg/kg IV/ IO (max 50 mg), may repeat once in 3 min
▼
→ If wheezing present:
►Albuterol 5 mg (6 mL) nebulize continuous as tolerated
▼
If signs or symptoms of poor perfusion:
► Establish IV/IO access
►Infuse 20 mL/kg NS bolus (Max 250 mL) may repeat twice to maintain perfusion
→ ALS escort to nearest PRC or BHO if no response to therapy or condition worsens
If cardiac arrest occurs, treat using cardiac arrest standing orders (SO-P-40)
1:10,000 = 0.1mg/mL
1:1000 = 1mg/mL