Any of the following is acted on immediately. In anaphylaxis, epinephrine is given FIRST and EMS is activated immediately after — epinephrine is never delayed.
Red flags — act immediately
Anaphylaxis — rapid onset of hives with airway or respiratory compromise, hypotension, gastrointestinal symptoms, or a sense of doom → give epinephrine IM per order or auto-injector FIRST, then activate EMS; position supine with the legs raised unless dyspneic; do not delay epinephrine.
Angioedema with airway involvement — swelling of the lips, tongue, or throat → give epinephrine per order if anaphylaxis features are present and activate EMS (cross-reference Mouth/Oral, Respiratory).
A single temperature ≥100.4°F (38°C) in an immunosuppressed or neutropenic patient → neutropenic-fever emergency — urgent evaluation (cross-reference Hematologic).
A serious or rapidly progressing infection in an immunocompromised patient → urgent evaluation; notify.
An expired or absent auto-injector in an at-risk patient → obtain a replacement urgently; notify.
Signs of severe immunosuppressant toxicity → hold per order and notify urgently.
