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Anaphylaxis — ABEM Board MCQ

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EasyEmergency MedicineAnaphylaxisABEM Board

A patient with anaphylaxis to peanuts arrives hypotensive and wheezing. First-line drug and dose?

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Correct answer: A — Epinephrine 0.3-0.5 mg of 1 mg/mL IM into lateral thigh

IM epinephrine 0.3-0.5 mg (1 mg/mL) in the lateral thigh is first-line and may repeat every 5-15 minutes. Antihistamines and steroids are adjuncts; albuterol treats bronchospasm only; IV epinephrine bolus is dangerous outside arrest.

Reference: AAAAI/ACAAI Practice Parameter (2020): Anaphylaxis