In anaphylaxis, when should adrenaline dose be repeated?

• A. Never repeat.
• B. Only after 24 hours.
• C. Repeat only if EMS advises.
• D. If symptoms persist, repeat adrenaline dose per local protocol.

Answer: (D)

Anaphylaxis can progress even after the first adrenaline dose, so the goal is to keep symptoms from worsening and to support breathing and circulation. If symptoms persist or recur after the initial dose, give another dose according to local protocol. This approach reflects that ongoing severe signs require additional epinephrine to maintain improvement, rather than waiting or assuming EMS will guide it later. Do not delay or wait a day to repeat, and follow the local guidelines on timing and dosing for repeat administrations, typically at short intervals until symptoms settle.