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Refractory anaphylaxis — DIPIMC MCQ

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HardResuscitationRefractory anaphylaxisDIPIMCDipIMC

A patient with anaphylaxis has received two doses of intramuscular adrenaline and a fluid load, but remains hypotensive and wheezy. An experienced clinician is present with full monitoring.

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Correct answer: C — Start a low-dose intravenous adrenaline infusion with continuous monitoring.

Refractory anaphylaxis that fails to respond to repeated intramuscular adrenaline and fluids is managed with a low-dose intravenous adrenaline infusion delivered by an experienced clinician with cardiac monitoring. A 1 mg intravenous bolus is the cardiac arrest dose and risks serious harm in a perfusing patient. Antihistamines do not treat airway or circulatory compromise.

Reference: Resuscitation Council UK Guidelines (2025)