What is the immediate management of anaphylaxis after exposure to a drug or food?

• A. Administer antihistamines and observe for response.
• B. Epinephrine IM as first-line; secure airway; call for emergency help; provide oxygen and IV fluids; monitor vitals.
• C. Administer corticosteroids as the only treatment.
• D. Wait for symptoms to resolve without intervention.

Answer: (B)

Anaphylaxis requires rapid reversal of airway compromise, bronchospasm, and shock, and the most effective initial intervention is epinephrine given intramuscularly, ideally into the mid-outer thigh. This single dose acts quickly to tighten dilated blood vessels (raising blood pressure), relax airway smooth muscle (reducing bronchospasm), and decrease mucosal edema, addressing the life-threatening features of the reaction. After administering epinephrine, secure the airway if swelling or breathing difficulties worsen, call for emergency help, provide high-flow oxygen, and establish intravenous access for fluids to support perfusion. Vitals should be monitored continuously, and repeat epinephrine doses may be necessary if symptoms persist or recur. While antihistamines and corticosteroids can be given as adjuncts, they do not act fast enough to treat the acute crisis and are not substitutes for epinephrine. The focus is on stopping progression and stabilizing the patient for ongoing care and transport.