EMS Protocol of the Week - Anaphylaxis (Adult)

Anaphylaxis is one of the rare protocols where you will actually find medication administration as early as the CFR (FDNY firefighter) level. In this protocol, if CFRs are the first on scene and recognize a patient in anaphylaxis, they will administer epinephrine via auto-injector while awaiting EMS backup. 

BLS will also administer IM epi, either by auto-injector or – in some instances – manually drawn up into a premarked syringe. However, EMTs require OLMC approval to give a second dose, regardless if they themselves gave the first epi or the CFRs did. This highlights the importance of checking with crews which meds were given, and by whom. BLS is also equipped to administer albuterol for any wheezing noted.

ALS providers on scene will do all manner of ALS stuff – advanced airway management if needed, IV fluids, steroids, diphenhydramine, ipratropium, and repeat epi if instructed by OLMC. Any further issues with respiratory or hemodynamic status are referred to appropriate protocols for additional management.

That’s it for this week, but I bet you’re all…itching…to find out what happens for pediatric patients in anaphylaxis? Stay tuned, faithful readers!

www.nycremsco.org or the protocol binder for more!

 Dave