Are there absolute contraindications to epinephrine in anaphylaxis under ICEMA standing orders?

• A. Yes
• B. No
• C. Only in patients with pheochromocytoma
• D. Only if there is a history of arrhythmia

Answer: (B)

Epinephrine is the first-line treatment for anaphylaxis, and in ICEMA standing orders there are no absolute contraindications to its use. In a life-threatening reaction, the benefits of reversing airway swelling, vasodilation, and shock far outweigh the potential risks of epinephrine’s side effects such as tachycardia or hypertension. While certain conditions (like pheochromocytoma or a history of arrhythmias) may warrant caution and closer monitoring, they do not automatically prohibit administration in anaphylaxis. Therefore, there are no absolute contraindications under these standing orders.