Which medication is part of the no (mild) evidence of anaphylaxis protocol?

• A. Epinephrine 0.5 mg IM
• B. Diphenhydramine 50 mg IM/IV/IO/PO
• C. Albuterol 2.5 mg neb
• D. Hydrocortisone 100 mg IV

Answer: (B)

In mild allergic reactions without clear anaphylaxis, the focus is on relieving histamine-mediated symptoms rather than reversing airway or circulatory compromise. Diphenhydramine is an H1 antihistamine that helps with itching, hives, and flushing, making it a typical component of the no (mild) evidence of anaphylaxis protocol.

Epinephrine is the cornerstone for true anaphylaxis because it counteracts airway swelling, bronchospasm, and shock, so it isn’t part of the mild protocol. Albuterol would be used if bronchospasm is present, not as a standard for mild, non-progressing reactions. Hydrocortisone is a slower-acting steroid and is not a primary acute intervention in this context, so it isn’t the defining choice for the mild protocol either.