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Anaphylaxis with bronchospasm and hypotension — RCPSC EM MCQ

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EasyRespiratory emergenciesAnaphylaxis with bronchospasm and hypotensionRCPSC EM

CTAS 1: A 36-year-old develops wheeze, urticaria and throat tightness minutes after eating shellfish. Vitals are BP 82/44, HR 126, RR 30, SpO2 90%. Exam shows facial swelling and diffuse wheeze. IV access is being obtained. What is the most appropriate initial management?

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Correct answer: E — Intramuscular epinephrine in the lateral thigh

Anaphylaxis with hypotension and airway or breathing involvement requires prompt IM epinephrine. Adjuncts must not delay epinephrine and airway planning.

Reference: Canadian anaphylaxis practice; WAO anaphylaxis guidance