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Anaphylaxis — SCE Acute Medicine MCQ

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EasyAcute Rheumatological/Dermatological EmergenciesAnaphylaxisSCE Acute Medicine

A 35-year-old woman develops generalised urticaria, wheeze and dizziness five minutes after intravenous co-amoxiclav. Blood pressure is 82/48 mmHg and oxygen saturation is 90% on air. What is the most important immediate action?

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Correct answer: D — Give intramuscular adrenaline 500 micrograms into the anterolateral thigh

Airway, breathing and circulation compromise after drug exposure indicates anaphylaxis, and IM adrenaline is the first-line treatment. Antihistamines and steroids are adjuncts and must not delay adrenaline. Tryptase can support diagnosis later but is not a pre-treatment test. The pearl is that delayed adrenaline is a major contributor to poor anaphylaxis outcomes.

Reference: Resuscitation Council UK Anaphylaxis guideline 2021