Your patient is a seven-year-old girl with a history of bee-sting anaphylaxis. She was stung by a bee and nearly immediately began having difficulty swallowing and breathing. Her father administered her prescribed 0.15 mg epinephrine auto-injector without result. On your arrival, the patient responds to painful stimuli; has labored, rapid, wheezing respirations; a heart rate of 60; and a blood pressure of 92/60 mmHg. Which of the following is the best sequence of treatment for this patient?

Question

Quizplus · Accepted Answer

In a case of anaphylaxis, the first-line treatment is epinephrine. Since the auto-injector did not work, the next step is to administer epinephrine 1:10,000 intravenously to rapidly increase blood pressure and reverse bronchoconstriction. Administration of diphenhydramine IV is also recommended as it can help with relief of itching and rash, but it should not delay administration of epinephrine as it is not a first-line treatment. IM administration of epinephrine is not recommended in severe anaphylaxis as there is delayed and unpredictable absorption.

Your Patient Is a Seven-Year-Old Girl with a History of Bee-Sting