Date Published

February 15, 2012

Updated For

ALS PCS Version ALS PCS Version 5.2


Question: With the assumption that the Cardiac Arrest Medical Directive applies to patients > 30 days, and the Neonate Resuscitate Medical Directive applies to patients < 30 days, can we administer Epi to Anaphylaxis VSA patients under the age of 30 days? (We realize this is a VERY rare what-if).


 You are right. This is a rare case but a fair question as it is not addressed in the directive. The SWORBHP Medical Council would suggest that the Neonatal Resuscitation Medical Directive be followed in this situation (i.e. - no IM epi if < 30days). It would be rare to have a neonate arrest from anaphylaxis, and if they did, it would be harder still to ascertain that anaphylaxis was the etiology vs sepsis or congenital heart disease which would be significantly more common. With any of these etiologies, rapid transport, optimal CPR and oxygenation would be the key steps in management.



Epinephrine (Epi), Pediatric Paediatric (Peds Paeds), Protocols (Protocol) Medical Directives (Medical Directive), Vital Signs Absent (VSA)

Additional Resources

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