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.
ADULT
Allergic Reaction or Anaphylaxis
Algorithm
New UPDATED 4/1/2019
Standing Orders: Allergic reactions can be mild or severe (anaphylaxis), treat based on the following assessment findings:
Allergic Reaction Includes:
(rash, urticaria, and vital signs stable):
▼
→ Pulse oximetry, if SPO2 less than 95%
→ High flow oxygen by mask as tolerated
Allergic Reaction Includes:
(facial/cervical angio-edema):
▼
►Epinephrine 0.5 mg IM Lateral Thigh area (1 mg/mL), once
(Do not administer if history of cardiac disease or Epi pen given prior to arrival)
▼
►Diphenhydramine 50 mg IM / IV, once
(Do not administer if given prior to arrival)
▼
→ Pulse oximetry, if SPO2 less than 95%
►Oxygen by mask or nasal cannula
→ ALS Escort
Allergic Reaction Includes:
(wheezing or hypoxia - SPO2 < 95%):
▼
► High flow oxygen by mask as tolerated.
▼
►Epinephrine 0.5 mg IM Lateral Thigh area (1 mg/mL), may repeat twice (every 5 min)
(If Epi pen given PTA, consider that the first dose)
▼
→ Pulse oximetry, if SPO2 less than 95%
►Oxygen by mask or nasal cannula
►Albuterol 5mg (6 mL) nebulize continuous as tolerated
▼
►Diphenhydramine 50 mg IV / IM, once
(Do not administer if given prior to arrival)
→ ALS Escort
Allergic Reaction Includes:
(hypotension, respiratory distress, impending airway obstruction) (BHC)
▼
► High flow oxygen by mask as tolerated
▼
►Epinephrine 0.5 mg IM Lateral Thigh area (1 mg/mL)
→ Establish IV/IO access
▼
►Normal Saline, infuse 250 mL IV/IO
(Repeat up to 1 liter max to maintain adequate perfusion)
▼
►Epinephrine 0.5 mg IM Lateral Thigh area (1 mg/mL) or Epinephrine 0.3 mg IV/IO, may repeat once in 5 min
(Total of 2 doses of Epi can be given before Base Contact)
▼
►Diphenhydramine 50 mg IV / IO / IM, once
(Do not administer if given prior to arrival)
▼
→ Pulse oximetry, if SPO2 less than 95%
►Oxygen by mask or nasal cannula
►Albuterol 5mg (6 mL) nebulize continuous as tolerate
→ ALS escort to nearest appropriate PRC; Base Hospital Contact if no response to therapy or condition worsens
1:10,000 = 0.1mg / 1mL
1:1000 = 1mg / 1mL