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  • Anaphylaxis Prehospital Protocol

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    Diah Kris Ayu
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    This document outlines treatment protocols for allergic reactions and anaphylaxis. It provides steps for assessing airway, breathing, circulation and perfusion. For patients with adequate perfusion, it recommends epinephrine injection and albuterol for wheezing. For poor perfusion, it recommends epinephrine slow IV push or IM injection, fluid bolus, and dopamine if hypotension persists. It allows for repeating epinephrine doses and adding diphenhydramine. Epinephrine is identified as the primary treatment for respiratory distress or poor perfusion from allergic reactions.

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    This document outlines treatment protocols for allergic reactions and anaphylaxis. It provides steps for assessing airway, breathing, circulation and perfusion. For patients with adequate perfusion, it recommends epinephrine injection and albuterol for wheezing. For poor perfusion, it recommends epinephrine slow IV push or IM injection, fluid bolus, and dopamine if hypotension persists. It allows for repeating epinephrine doses and adding diphenhydramine. Epinephrine is identified as the primary treatment for respiratory distress or poor perfusion from allergic reactions.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    12 views1 page

    Anaphylaxis Prehospital Protocol

    Uploaded by

    Diah Kris Ayu
    This document outlines treatment protocols for allergic reactions and anaphylaxis. It provides steps for assessing airway, breathing, circulation and perfusion. For patients with adequate perfusion, it recommends epinephrine injection and albuterol for wheezing. For poor perfusion, it recommends epinephrine slow IV push or IM injection, fluid bolus, and dopamine if hypotension persists. It allows for repeating epinephrine doses and adding diphenhydramine. Epinephrine is identified as the primary treatment for respiratory distress or poor perfusion from allergic reactions.

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    © All Rights Reserved
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    of 1

    DEPARTMENT OF HEALTH SERVICES (PARAMEDIC, MICN)

    COUNTY OF LOS ANGELES REFERENCE NO. 1242


    TREATMENT PROTOCOL: ALLERGIC REACTION / ANAPHYLAXIS
    1. Simple hives do not require field treatment
    2. Basic airway
    3. Pulse oximetry
    4. Oxygen prn
    5. Cardiac monitor: document rhythm and attach ECG strip if dysrhythmia identified
    6. Advanced airway prn
    7. Venous access prn
    ADEQUATE PERFUSION POOR PERFUSION
    8. Epinephrine 8. Epinephrine
    0.3mg (1:1,000) IM 0.1mg (1:10,000) slow IV push
    Pediatrics: See Color Code Drug If unable to obtain venous access,
    Doses/L.A. LA County Kids 0.5mg (1:1,000) IM
    0.01mg/kg (1:1,000) IM, maximum Pediatrics: See Color Code Drug
    single dose 0.3mg for patient weight Doses/L.A. LA County Kids
    30kg or greater 0.01mg/kg (1:1,000) IM, maximum
    9. If wheezing: single dose 0.3mg for patient weight
    Albuterol 30kg or greater
    5mg via-hand-held nebulizer 9. If hypotensive,
    Pediatrics: See Color Code Drug Normal Saline fluid challenge
    Doses/L.A. LA County Kids Adult: 10ml/kg IV at 250ml increments
    10. ESTABLISH BASE CONTACT (ALL) Use caution if rales present
    11. If symptoms persist: Pediatric: 20ml/kg
    Epinephrine 10. ESTABLISH BASE CONTACT (ALL)
    0.3mg (1:1,000) IM 11. If symptoms persist:
    May repeat every 20min two times for Epinephrine
    a total of 3 doses 0.1mg (1:10,000) slow IV push
    Pediatrics: See Color Code Drug May repeat every 3min
    Doses/L.A. LA County Kids If unable to obtain venous access,
    Albuterol 0.3mg (1:1,000) IM
    5mg vial hand-held nebulizer May repeat every 20min two times
    May repeat prn Pediatrics: See Color Code Drug
    Pediatrics: See Color Code Drug Doses/L.A. LA County Kids
    Doses/L.A. LA County Kids 12. If fluid challenge unsuccessful:
    Diphenhydramine Dopamine (Adult Administration Only)
    50mg slow IV push 400mg/500ml NS IVPB
    If unable to obtain venous access, Start at 30mcgtts/min titrate to SBP 90-
    50mg deep IM 100mmHg and signs of adequate
    May repeat in 15min one time, total perfusion or to a maximum of
    maximum dose 100mg 120mcgtts/min
    Pediatrics: See Color Code Drug 13. If wheezing:
    Doses/L.A. LA County Kids Albuterol
    12. Reassess for potential deterioration 5mg vial hand-held nebulizer
    May repeat prn
    Pediatrics: See Color Code Drug
    Doses/L.A. LA County Kids
    SPECIAL CONSIDERATIONS
    Monitor vital signs frequently after administration
    Epinephrine is the drug of choice for allergic reactions with any respiratory or perfusion
    component

    EFFECTIVE DATE: 7-1-11 PAGE 1 OF 1


    REVISED: 10-01-2013
    SUPERSEDES: 09-01-13

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