Question: I was wondering if there was a reason that, according to the standing orders, if you want to give a patient under 25 kg Gravol you can call the BHP for an order but there is no stipulation for giving Benadryl to a patient under 25 kg's. Is this on purpose? It suggests to me I should not consider calling the BHP for an order for Benadryl for an under 25 kg pt. Is this correct?
Thanks for the question. The purpose in creating identical charts for dosing of dimenhydrinate and diphenhydramine was to avoid having paramedics calculate the medical math required to dilute dosing below 25kg for either drug. In reviewing the medical directives, the conditions for both medications stipulate that the patient must be greater or equal to 25kg. Neither medical directive clearly stipulates that you should call the BHP for an order for either drug if the patient weighs less that 25kg. Given the relative infrequency of use for either medication for patients under 25kg coupled with the complexity of the medical math, when balanced by the benefit of either drug, we would suggest rapid transport for patients under 25kg as per the medical directive.