Adrenaline anaphylaxis — DipIMC MCQ

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EasyPre-Hospital PharmacologyAdrenaline anaphylaxisDipIMC

A 62-year-old develops stridor and hypotension after eating nuts at a restaurant. He is conscious with a rapid pulse. What is the most appropriate drug/dose?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Intramuscular adrenaline 500 micrograms

Explanation lettering: E = shown as C · C = shown as D · D = shown as E

C is correct: IM adrenaline is the key first-line medicine for adult anaphylaxis with airway or circulatory compromise. A is less suitable because antihistamine is adjunctive and must not delay adrenaline in anaphylaxis; B is less suitable because the dose is below standard severe adult asthma nebuliser dosing; D is less suitable because analgesia is important but does not replace the first physiological intervention; E is less suitable because cardiac-arrest adrenaline dosing is inappropriate in a perfusing patient. The most tempting alternative is therefore suboptimal because it either delays the time-critical pre-hospital intervention or sends the patient to the wrong level of care. The key DipIMC principle is focused cABCDE decision-making with early pre-alert, triage or retrieval escalation when the scene physiology demands it.

Reference: JRCALC Medicines Guidelines; Resuscitation Council UK; BNF