Moderate to Severe Allergic Reaction

Medical Directive

Indications: Exposure to a probable allergen and signs and/or symptoms of a moderate to severe allergic reaction (including anaphylaxis)

Epinephrine: If patient does not have sensitivity or an allergy to epinephrine administer 0.01mg/kg of epinephrine 1:1000 to a maximum dose of 0.5mg. Only 1 dose is to be administered.

If the patient weighs ≥ 10kg but < 25kg you may administer epinephrine 1:1000 via pediatric autoinjector (0.15mg).

If the patient weighs ≥ 25kg administer epinephrine 1:1000 via adult autoinjector (0.3mg).

Diphenhydramine: If the patient weighs ≥ 25kg but < 50kg administer diphenhydramine 25mg IV or IM.   If the patient weighs ≥ 50kg administer 50mg IV or IM. Only 1 dose is to be administered.


Epinephrine (1:1,000)IM
Dose0.01 mg/kg
Max Single Dose0.5mg
Dosing IntervalMinimum 5 minutes
Max No of Doses2
Diphenahydramine≥25kg to <50kg≥25kg to <50kg≥50kg≥50kg
Max Single Dose25mg25mg50mg50mg
Dosing IntervalN/AN/AN/AN/A
Max No of Doses1111