- Onset and location
- Insect sting/bite
- Food allergy/exposure
- Medication allergy/exposure
- New clothing, soap, detergent
- Past history of reactions
- Past medical history
- Ace inhibitors
- Respiratory distress
- Chest/throat constriction
- Difficulty swallowing
- Urticaria (rash only)
- Anaphylaxis (systemic effect)
- Shock (vascular effect)
- Angioedema (drug induced)
- Aspiration/airway obstruction
- Vasovagal event
DO NOT use this order if chest pain is thought to be cardiac in origin
Hives/rash only; No respiratory component or dystonic reaction ?
- Notify receiving facility or contact Medical Control if needed.
Immediately begin rapid treatment
if any of the following S/S are present.
Wheezing, airway involvement, hypotension, difficulty swallowing, swollen tongue or lips ?
- Epinephrine 1: 1,000 0.5 mg IM, may be repeated every 15 mins; max 4 doses.
- Normal Saline up to a 1,000 mL to reverse the signs of hypotension.
Respiratory distress ?
- Notify receiving facility or contact Medical Control
- Ace inhibitors can cause isolated angioedema (i.e., lip swelling without airway involvement).
- Common Ace inhibitors include Zestril (Lisinopril), Tritace (Ramipril), Renitec (Enalapril), Vasostad (Captopril), Cibacen (Benazepril).
- Methylprednisolone (Solumedrol) 125 mg IV can be administered to isolated angioedema caused by Ace Inhibitors.
- An Adult Epi-pen auto-injector can be used in lieu of Epinephrine 1:1,000 0.3mL IM, may be repeated once in 5 minutes by a basic EMT