24th May 2025

You are part of the medical team working in the emergency department resuscitating a patient suspected of anaphylaxis.

You are part of the medical team working in the emergency department resuscitating a patient suspected of anaphylaxis. The patient is hypoxic, hypotensive, tachycardic and has an erythematous rash overlying their trunk and limbs twenty minutes after eating a protein bar. The patient has had previous anaphylactic episodes to peanuts and soya. They have a single adrenaline auto-injector prescribed and administered this independently prior to paramedics’ arrival. A second dose was administered en route to hospital with a third dose given on arrival.

Current observations include a respiratory rate of 40, a peripheral oxygen saturation of 93% on 15L via a non-rebreathe mask, a blood pressure of 67/35 mmHg, a heart rate of 131 beats per minute and a temperature of 36.0°C. The patient opens their eyes to pain. Which of the following is the most appropriate management?

Select the SINGLE most appropriate option from the list below. Select ONE option only