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ACEM Fellowship

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A practice question

Choose an answer and it is marked, with the explanation. From ACEM Fellowship Practice Questions: 8 Clinical Cases.

Question 11 mark

A 34-year-old develops generalised urticaria, wheeze and dizziness minutes after an IV antibiotic. They are pale, with a blood pressure of 78/46 mmHg. What is the immediate treatment?

Give IM adrenaline promptly for anaphylaxis with airway or breathing compromise or hypotension; an adult dose is 0.5 mg of 1 mg/mL solution into the anterolateral thigh, repeated after 5 minutes if needed. Call for help, position the patient safely, provide oxygen and IV crystalloid as indicated. Hydrocortisone and antihistamines do not replace adrenaline or treat the immediate circulatory threat; do not delay treatment for transfer.

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