Policy Manual sample

MDT Home Health Care Agency, Inc. 4 RECOMMENDED ANAPHYLAXIS MEDICATIONS TO BE GIVEN ONLY WITH A PHYSICIAN’S ORDER: 1) EPINEPHRINE SUBCUTANEOUS: 0.01 ml/kg to a maximum of 0.3-0.5ml of 1:1000 aqueous solution (1mg/ml). May be repeated x 3 doses as ord ered. INTRAVENOUS : 1 to 3 ml of 1:10,000 aqueous solution (0.1mg/ml) given over 10 minutes or 1 to 4 ug/min. (o.25 to 1 ml/minute of a solution of 4 ug/ml made with 1 ml of 1:1000 epinephrine in 250 ml of IV fluid. 2) DIPHENHYDRAMINE (BENADRYL) MAY BE GIVEN PO/IV/IM EVERY 6 HOURS AS ORDERED: 1.25 mg/kg/dose to a max of 50 mg