Your Patient Is a 48-Year-Old Female Who Is Supine on the Floor

Your patient is a 48-year-old female who is supine on the floor of a neighborhood health clinic. She became unconscious after receiving 250 mg of IM doxycycline. Clinic staff reports that the patient "broke out in hives and lost consciousness." The patient is being ventilated by bag-valve mask and has an IV of normal saline running wide open. A nurse practitioner on the scene informs you that, before your arrival, he administered 2 doses of 0.5 mg of epinephrine SC, 50 mg of diphenhydramine IV, and 1 L of NS. HR = 138; BP = 84/60; RR = 12/min, assisted with BVM; SaO₂ = 94%. Of the following, which is the most appropriate continued treatment of this patient?

A) Intubate, Solu-Medrol IV, 250 cc NS fluid challenge, transport.
B) Intubate, administration of dopamine IV infusion, rapid transport.
C) Continue administering fluids and transport to the nearest facility.
D) Initiate a second IV of NS wide open, intubate and hyperventilate, transport.