In an anaphylactic reaction, what are the immediate steps a dental nurse should take?

• A. Administer intramuscular adrenaline (epinephrine) 0.3 mg (1:1000) into the mid-outer thigh as soon as possible; call emergency services; place patient in a position that maintains airway and breathing; deliver high-flow oxygen and monitor; repeat dose if symptoms persist per local protocol.
• B. Administer intravenous fluids only.
• C. Give antihistamines only.
• D. Ignore and observe.

Answer: (A)

Immediate recognition and treatment of anaphylaxis rely on giving adrenaline quickly, along with urgent medical support and airway/breathing protection. The intramuscular dose of 0.3 mg (1:1000) into the mid-outer thigh is the fastest, most reliable way to deliver adrenaline to adults in this situation, restoring airway tone, blood pressure, and perfusion. Administer it as soon as anaphylaxis is suspected and then call emergency services so advanced care can follow. Keep the patient in a position that preserves airway and breathing and provide high-flow oxygen while continuing to monitor their condition, since deterioration can be rapid. If symptoms persist or recur, repeat the adrenaline dose according to local protocol.

Relying on intravenous fluids alone does not address the airway swelling or the rapid drop in blood pressure, and antihistamines do not reverse the life-threatening effects quickly enough. Ignoring the reaction is dangerous.