Paramedic Kardex

ADULT

Allergic Reaction or Anaphylaxis

Algorithm

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Allergic Reaction: Mild (rash, urticarial, and vital signs stable): → Pulse oximetry, if SPO2 less than 95%
▼
High flow oxygen by mask as tolerated.

 

 

Allergic Reaction: Moderate (facial/cervical angio-edema or wheezing):

→ Pulse oximetry, if oxygen saturation less than 95%
►High flow oxygen by mask as tolerated.
▼
►Diphenhydramine 50 mg IM / IV
►Epinephrine 0.3 mg IM (1 mg/mL)
BHO for history of cardiac disease, CHF, Chest Pain, or age > 40 years-old

 

→ If wheezing present:

►Albuterol: 5mg (6mL) nebulize continuous as tolerated

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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 0.3 mg Slow IV / IO (0.1 mg/mL) or Epinephrine 0.3 mg IM (1 mg/mL)
►Diphenhydramine 50 mg IV / IO / IM
►Normal Saline, infuse 250 mL, repeat up to max 1 liter to maintain adequate perfusion.

▼
→ If wheezing present:
►Albuterol 5mg (6 mL) nebulize continuous as tolerated.

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→ ALS escort to nearest appropriate PRC; Base Hospital Contact if no response to therapy or condition worsens

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1:10,000 = 0.1mg / 1mL

1:1000 = 1mg / 1mL​