In adult patients, epinephrine standing orders apply to which condition?

• A. Severe Anaphylaxis
• B. Severe Bronchospasm
• C. Both Severe Anaphylaxis and Severe Bronchospasm
• D. Mild allergic reaction

Answer: (A)

Epinephrine standing orders for adults are reserved for life-threatening allergic reactions with potential airway or circulation compromise. In anaphylaxis, epinephrine acts quickly to reverse airway swelling, relieve bronchospasm, and support blood pressure by constricting vessels and increasing heart output. This makes it the condition for which EMS can administer epinephrine without direct physician approval under standing orders.

Severe bronchospasm by itself is usually managed with inhaled bronchodilators, and mild allergic reactions don’t require epinephrine. Therefore, the scenario that fits the standing orders best is severe anaphylaxis, not isolated bronchospasm or a mild allergy.