Anaphylaxis with pulse — DipIMC MCQ
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Correct answer: E — Intramuscular adrenaline 500 micrograms
Explanation lettering: E = shown as A · A = shown as C · C = shown as D · D = shown as E
D is correct: Adult anaphylaxis with circulation is treated first-line with IM adrenaline 500 micrograms into the anterolateral thigh. A is less suitable because rapid IV benzodiazepine bolus carries avoidable respiratory risk; B is less suitable because it is a common auto-injector dose rather than the adult healthcare dose; C is less suitable because cardiac-arrest adrenaline dosing is inappropriate in a perfusing patient; E is less suitable because this is not a definitive treatment for the condition described. 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: Resuscitation Council UK Guidelines 2025; JRCALC Guidelines