C. 0.3 ml adrenaline intramuscularly – Explanation
Adrenaline is by far the most important drug in anaphylaxis and should be given as
soon as possible. This girl is 9 years old hence 0.3ml of adrenaline is appropriate for her
age (6 to 12 years old).
The recommended doses for adrenaline are as follows:
| Age | Adrenaline Dosage |
| < 6 months | 150 micrograms (0.15 ml 1 in 1,000) |
| 6 months to 6 years | 150 micrograms (0.15 ml 1 in 1,000) |
| 6-12 years | 300 micrograms (0.15 ml 1 in 1,000) |
| Adult and child > 12 years | 500 micrograms (0.5 ml 1 in 1,000) |
Adrenaline is the most important drug in anaphylaxis and should be given
intramuscularly as soon as possible. Once adrenaline is administered, hydrocortisone
and chlorpheniramine should follow
ANAPHYLAXIS ALGORITHM:
- ABC
- Give high-flow oxygen
- Lay the patient flat
- Adrenaline (epinephrine) intramuscularly (IM) in the anterolateral aspect of the
middle third of the thigh (safe, easy, effective).
ANAPHYLAXIS FEATURES
Clinical features
The speed of onset and severity depends on the nature and the amount of exposure
with the stimulus, but the onset is usually in minutes or hours.
Respiratory:
- Swelling of lips, tongue, pharynx, and epiglottis
o The fear here is that it may lead to complete upper airway occlusion - Lower airway involvement is similar to acute severe asthma e.g. dyspnoea, wheeze
(bronchospasm), chest tightness, hypoxia, and hypercapnia
Skin
- Pruritus, erythema, urticaria, and angio-oedema
Cardiovascular
- Peripheral vasodilation and increased permeability cause plasma leakage from the
circulation, thus causing hypotension, and shock
