Moderate to Severe Allergic Rxn Medical Directive

Question 1

What are the indications?

Answer 1

• Exposure to a probable allergen, AND S/S of a moderate to severe allergic rxn (including anaphylaxis)

Question 2

What are the two medications for this directive?

Answer 2

• Epinephrine and Diphenhydramine

Question 3

What are the conditions for Epinephrine?

Answer 3

• Other= for anaphylaxis only

Question 4

What are the conditions for diphenhydramine?

Answer 4

• Weight= >25 kg

Question 5

What are the contraindications for epinephrine?

Answer 5

• Allergy to sensitivity to epinephrine

Question 6

What are the contraindications for diphenhydramine?

Answer 6

• Allergy or sensitivity to diphenhydramine

Question 7

What is the treatment for epinephrine?

Answer 7

• Route= IM
• Concentration= 1:1000
• Dose= 0.01mg/kg
• Max. single dose= 0.5mg
• Dosing interval= Minimum 5 min
• Max. # of doses= 2

Question 8

What is the treatment for diphenhydramine? (weight= >25kg to <50 kg)

Answer 8

• Route= IM/IV
• Dose= 25mg
• Max. single dose= 25mg
• Dosing interval= n/a
• Max. # of doses= 1

Question 9

What is the treatment for diphenhydramine? (weight= >50 kg)

Answer 9

• Route= IM/IV
• Dose= 50mg
• Max. single dose= 50mg
• Dosing interval= n/a
• Max. # of doses= 1

Question 10

What are the clinical considerations?

Answer 10

• Epinephrine administration takes priority over IV access
• IV administration of diphenhydramine applies to PCPs authorized for PCP Autonomous IV