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Paediatric anaphylaxis dosing — DIPIMC MCQ

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ModeratePaediatric and Obstetric EmergenciesPaediatric anaphylaxis dosingDIPIMCDipIMC

A 9-year-old develops lip swelling, widespread urticaria and wheeze minutes after eating a biscuit containing nuts. He is distressed and his breathing is laboured. What is the most appropriate first dose of intramuscular adrenaline (1:1000)?

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Correct answer: D — 300 micrograms intramuscularly

For a child aged 6 to 12 years, the intramuscular dose of adrenaline (1:1000) in anaphylaxis is 300 micrograms, repeated after five minutes if there is no improvement. A dose of 150 micrograms is for children aged 6 months to 6 years, and 500 micrograms is the dose for adults and those over 12. Intravenous adrenaline is reserved for refractory cases given by experienced clinicians. Pearl: the anterolateral thigh is the preferred site for the intramuscular injection.

Reference: Resuscitation Council UK (Emergency Treatment of Anaphylaxis)