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Anaphylaxis with bronchospasm — RCPSC EM MCQ

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ModerateRespiratory emergenciesAnaphylaxis with bronchospasmRCPSC EM

A 56-year-old woman with food allergy develops throat tightness, wheeze and urticaria five minutes after eating. Blood pressure is 86/50 mmHg and oxygen saturation is 91%. She has already received salbutamol from paramedics without improvement. What is the most appropriate initial management?

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Correct answer: C — Give intramuscular epinephrine immediately and repeat as needed while supporting airway and circulation

Anaphylaxis with airway symptoms, bronchospasm and hypotension requires immediate IM epinephrine. Antihistamines and bronchodilators are adjuncts and must not delay epinephrine.

Reference: Canadian Society of Allergy and Clinical Immunology anaphylaxis guidance; ACLS