Anaphylaxis & Allergy
Recognition
- Acute onset of hives, itching, or flushing plus respiratory compromise or hypotension
- Two or more body systems involved after a likely exposure
BLS
- Epinephrine 0.3 mg IM to the anterolateral thigh. Repeat every 5–15 minutes if symptoms persist.
- High-flow oxygen. Position supine; semi-recumbent if respiratory distress.
- Initiate rapid transport per the Evacuation protocol.
ALS
- IV access. Normal saline 1–2 L IV bolus for hypotension.
- Diphenhydramine 25–50 mg IV/IM as an adjunct — never a substitute for epinephrine.
Notes & precautions
- Biphasic reactions occur in up to 20% — all patients who receive epinephrine require transport and observation.
- Questions en route? OLMC: (541) 555-0144