Adrenaline Dose Anaphylaxis — MFDS Part 1 MCQ

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ModerateHuman DiseaseAdrenaline Dose AnaphylaxisMFDS Part 1

During dental treatment, an adult develops rapidly progressive facial swelling, wheeze and hypotension. Anaphylaxis is suspected, and the patient is not in cardiac arrest. Which initial dose of intramuscular adrenaline should the dentist administer?

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Correct answer: C — 500 micrograms (0.5 mL of 1:1000)

The correct answer is C: 500 micrograms of adrenaline intramuscularly, equivalent to 0.5 mL of 1:1000 solution. The rapid onset of wheeze, facial swelling and hypotension indicates anaphylaxis with airway, breathing and circulatory involvement. Adrenaline should be injected into the anterolateral thigh and repeated at 5-minute intervals if the response is inadequate while emergency assistance is summoned. The 100- and 250-microgram doses would undertreat an adult. A 1000-microgram dose of 1:1000 is not the recommended adult intramuscular anaphylaxis dose and may be confused with the adrenaline dose used during cardiac arrest. The 1:10000 preparation is not the standard preparation for first-line intramuscular treatment of anaphylaxis in dental practice.

Reference: SDCEP Practice Support Manual, Medical Emergencies in the Dental Practice—Anaphylaxis section, May 2020. https://www.psm.sdcep.org.uk/media/3hlkptix/medical_emergencies_in_the_dental_practice.pdf