Date Published

March 28, 2019

Updated For

ALS PCS Version ALS PCS Version 5.2


Our directives state that we are allowed to administer 2 doses of epinephrine to a patient suffering from a severe allergic reaction and 1 does to a VSA patient who is expected to have become VSA secondary to anaphylactic shock. Does this mean we are allowed to give a 2nd and possibly 3rd dose of epinephrine to a patient by following the moderate to severe allergic reaction medical directive post ROSC?


Yes, this is correct. If your patient has achieved ROSC after suspected anaphylaxis and is still exhibiting signs of anaphylaxis, it is reasonable to follow the Moderate to Severe Allergic Reaction Medical Directive. Note, that in these reversible causes of arrest, and in the face of requiring further epinephrine, expedient transport to definitive care is paramount.



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