Question 1

A man self-administers aqueous epinephrine after experiencing a bee sting and developing angioedema and wheezing. What should the man do next?&#10;A) Obtain transport to an emergency department immediately.&#10;B) Repeat the epinephrine dose if needed and notify a physician of the episode.&#10;C) Resume normal activity if symptom free after 30 to 60 minutes.&#10;D) Take oral diphenhydramine and report any symptoms to a provider.

Accepted Answer

A bee sting can cause severe allergic reactions, such as anaphylaxis, which is a life-threatening medical emergency. Therefore, obtaining transport to an emergency department immediately is the most appropriate action. The man may require additional medical interventions, such as oxygen, intravenous fluids, and close monitoring of his blood pressure and heart rate.

Question 2

A child with no previous history of asthma is brought to the emergency department with wheezing, stridor, and shortness of breath. When the child is started on oxygen and given a nebulized bronchodilator treatment, the treatment team notes a wheal and flare rash on the child's trunk. What medication will be given immediately?

A) Inhaled racemic epinephrine
B) Intramuscular epinephrine
C) Intravenous diphenhydramine
D) Intravenous ranitidine

B

Accepted Answer

The child is experiencing anaphylaxis, which is a severe allergic reaction. The presence of wheezing and shortness of breath, along with the development of a wheal and flare rash, is highly suggestive of this. The immediate treatment for anaphylaxis is intramuscular epinephrine, which acts as a potent bronchodilator and vasoconstrictor, reversing the symptoms of anaphylaxis quickly and effectively. Inhaled racemic epinephrine may be used in mild cases, but it is unlikely to be as effective in this severe case. Intravenous diphenhydramine and ranitidine are helpful in treating allergic reactions, but they are not the immediate treatment for anaphylaxis.

Deck 23: Anaphylaxis