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Febrile convulsion prolonged — DipIMC MCQ

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HardPaediatric and Obstetric EmergenciesFebrile convulsion prolongedDipIMC

A 3-year-old with anaphylaxis received IM adrenaline 150 micrograms five minutes ago. Despite positioning, oxygen and fluid resuscitation, wheeze and hypotension persist. What is the next drug action?

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Correct answer: D — Repeat intramuscular adrenaline 150 micrograms into the anterolateral thigh

The best answer is “Repeat intramuscular adrenaline 150 micrograms into the anterolateral thigh”. Persistent airway, breathing or circulatory compromise after five minutes requires a repeat age-appropriate IM adrenaline dose. For a child aged 6 months to 6 years that is 150 micrograms in the anterolateral thigh. Fluids and bronchodilators are adjuncts; antihistamine and hydrocortisone must not replace adrenaline. IV 1 mg adrenaline is a cardiac-arrest dose and is unsafe in a perfusing child.

Reference: Resuscitation Council UK, Emergency treatment of anaphylaxis: https://www.resus.org.uk/library/additional-guidance/guidance-anaphylaxis/emergency-treatment-anaphylactic-reactions