Question: Regarding Benadryl, in the auxiliary protocol it states that you cannot give Benadryl if the patient has taken a sedative or antihistamine in past 4 hours. This is not, however, indicated in the normal standing order protocol for Benadryl.

I am wondering if this is applicable as well if you arrive on scene with a patient who has taken Benadryl oral prior to your arrival. Do they still meet the protocol to give Benadryl even if they have already taken it? Should I still give it or withhold since they might have an overdose of Benadryl or have both the doses reacting at the same time? Would this also apply to a patient who has taken Gravol prior to EMS arrival as well?

Hope this can be clarified. I feel it’s a grey area that most of us don’t think about until put in the situation. Thanks.

Question: In a patient with an allergic reaction or anaphylaxis, who is experiencing nausea or vomiting, is it okay to treat them with Gravol after I have administered Benadryl?

Question: Recent call of a 40 years old woman with a past history of renal colic and experiencing intense low back pain that she likens to an exacerbation. She is a small woman at about 45 kg and a candidate for narcotics under the standing order for pain relief. Two questions: Firstly, we were unable to establish an IV after 2 attempts and the standing order specifies only the IV route of administration. Can morphine and/or fentanyl be given IM in this instance as a standing order? Secondly, her initial BP was 90/60. Given the patient’s size and her statement of usually having a low BP, can this reading of 90/60 be considered as normotensive? What if it was 85/60? Thanks in advance for your answer.