N.J. Admin. Code § 8:41-7.16

Current through Register Vol. 56, No. 11, June 3, 2024

Section 8:41-7.16 - Standing orders for allergic reaction/anaphylactic shock

(a) The following standing orders are authorized in the event that an adult patient presents with signs of generalized allergic findings such as urticaria with signs of acute significant respiratory distress and/or profound hypotension (systolic blood pressure less than or equal to 80 mmHg) with clinical evidence of shock, including altered mental status; cool, clammy or mottled skin; and/or delayed capillary refill.

1. Assess and secure airway;

2. Fifteen lpm of oxygen via NRB should be placed;

3. Administer 0.5 cc Epinephrine 1:1,000 subcutaneous and vigorously rub the area of injection;

4. Establish IV access and administer normal saline solution and initiate 300 cc fluid bolus. The bolus should be repeated once if blood pressure remains less than 100 systolic;

5. Administer 0.25 mg Epinephrine 1:10,000 IV over the course of one minute;

6. Administer 50 mg Diphenhydramine HCL IV;

7. If wheezing is present, administer 2.5 mg Albuterol/3 cc normal saline solution via nebulizer; and

8. Contact the medical command physician.

N.J. Admin. Code § 8:41-7.16