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Anaphylaxis positioning — DIPIMC MCQ

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ModerateResuscitationAnaphylaxis positioningDIPIMCDipIMC

A 45-year-old with anaphylaxis has received intramuscular adrenaline and is improving, but remains hypotensive. He feels faint and tells you he wants to sit upright and then stand, although he is still mildly breathless. What is the most appropriate advice regarding positioning?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Keep him lying flat with his legs raised

A hypotensive patient with anaphylaxis should be kept supine with the legs raised to support venous return, adjusting towards a more upright posture only if breathing difficulty demands it. Suddenly sitting or standing a hypotensive patient can precipitate cardiovascular collapse and death. A steep head-down tilt is not advised and can impair ventilation. Pearl: deaths have occurred when patients with anaphylaxis were moved abruptly into an upright position.

Reference: Resuscitation Council UK (Emergency Treatment of Anaphylaxis)