Anaphylaxis Management at St. Joseph’s Family Medical Centre

Medical Directive ID: 
Lead Contact Person: 
Jennifer Bass, RN
Physician/Nurse Lead: 
Dr. Laura Lyons, St. Joseph's Family Medicine Centre Director
Family Medicine - St. Joseph's Family Medical Centre
Approval By: 
Medical Advisory Committee
Original Effective Date: 
Wednesday, October 9, 2013
Revised Date: 
Wednesday, November 8, 2017
To Be Reviewed Date: 
Sunday, November 8, 2020
This Medical Directive Applies to the following sites: 
This Medical Directive Applies to the following patient population: 



The following steps describe the management of anaphylaxis. Steps 1 to 4 are meant to be done rapidly or simultaneously. The priority is prompt administration of epinephrine (step 2), which should not be delayed if earlier steps cannot quickly be completed.

1.The Registered Nurse (RN) at the family medical centre will notify an on-site physician or NP (if physiciannot available) immediately.

2.Promptly administer Epinephrine as stated in Medication/Drug Table. Call 911.

3.Place the patient in a recumbent position, elevating the feet if possible.

4.Establish an oral airway if necessary.

5.Administer oxygen; apply 2-4L via NP or 15L mask. It should be given to patients with cyanosis, dyspnea orany other severe reaction. Monitor with pulse oximetry if available.

6.As an adjunct to epinephrine administration in a non-hospital setting, follow the appropriate algorithm inAppendix 1 and arrange for rapid transport to an Emergency Department as necessary.


Click the link to view the entire medical directive in detail: 
St. Joseph's Family Medical Centre


SurnameKnown ByDate Signed
ChanNelsonJan 12 2018 07:08:10:993AM
El SadekImad HassanFeb 22 2020 12:23:48:863PM
JanSaadiaJan 21 2018 05:43:21:210PM
LyonsLauraFeb 5 2018 09:28:26:110AM
McNairSusanJan 12 2018 10:48:02:207AM
MintsoulisDanielleMar 2 2020 09:01:23:440PM
PetrellaRobMar 14 2018 02:37:24:127PM
RubaiyyatTaniaJan 12 2018 01:52:05:217PM
Stiller-MoldovanCassandraJan 22 2020 06:47:30:833PM
WongEricJan 16 2018 08:58:09:200AM