Otolaryngology Board Review Sample Questions

The correct answer is D. Epinephrine

Explanation: The acute management of an anaphylactic event requires immediate recognition and institution of therapy. Initial management is directed to the preservation of the airway and assessment of vital signs. Establishment of the airway should be done immediately while assessing the vital signs and placing the patient in the recumbent position with legs elevated. If the problem is predominantly respiratory (severe asthma or laryngeal oedema) without features of hypotension, the patient should be kept sitting up. Simultaneously, adrenaline should be administered. Injection in the vastus lateralis muscle (lateral thigh) produces a more rapid rise in blood adrenaline levels and, because of this desirable effect, has been suggested as the initial route of administration of choice. The dose in an adult is 0.3–0.5 mg [i.e. 0.3–0.5 mL of 1 in 1000 strength (1mg/mL)] intramuscularly. The dose in a young child is dependent on weight (0.01 mg per kg). For children between 1 and 6 years old, 0.15 mL of 1 in 1000 strength should be given