Question: Can you administer diphenhydramine to a patient that is in moderated to severe allergic reaction? The old directive was clear on this, which was allowable. The current directive leaves medics guessing treatment intervention. Epinephrine is indicated as a first round drug for anaphylaxis, which is understandable.

 Thanks for the question. We are sorry that you find the current directive leaves you guessing as to treatment intervention. Looking at the "Moderate to Severe Allergic Reaction Medical Directive", it does clearly list Diphenhydramine as indicated and the dosing chart is included. In anaphylaxis as you describe, given the seriousness of this condition, epinephrine should be the first drug to be delivered, however in a moderate to severe allergic reaction, diphenhydramine absolutely may be administered. Diphenhydramine may also be administered in the setting of anaphylaxis following Epinephrine.

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