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This form represents a general guideline only and is subject to the clinical judgement of the provider. All dosing for medications administered should be determined by the ordering provider. Last Updated 9/19/2017 PROTOCOL FOR IN-CLINIC ALLERGIC REACTIONS This protocol has a front and back page and should be used at the first sign of an allergic reaction. Please document vital signs, concerning physical exam findings and any medications administered in the table below with corresponding time. Turn this page over to review the protocol for management of an acute reaction.

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