Ten minutes after receiving a vaccine at a clinic, a 12 kg toddler develops generalized urticaria, wheeze and hypotension consistent with anaphylaxis. What is the correct immediate drug treatment?
- A Hydrocortisone 100 mg intravenously as the first-line drug
- B Adrenaline 0.5 mg (0.5 mL of 1:1000) intramuscularly in the anterolateral thigh
- C Adrenaline 0.12 mg (0.12 mL of 1:1000) intramuscularly in the anterolateral thigh ✓
- D Chlorpheniramine 2 mg intramuscularly, repeated after 15 minutes
Correct answer: C. Adrenaline 0.12 mg (0.12 mL of 1:1000) intramuscularly in the anterolateral thigh
Explanation
Adrenaline is the first-line treatment for anaphylaxis following immunization. The recommended dose is 0.01 mL per kg of 1:1000 adrenaline given intramuscularly into the anterolateral thigh, with a maximum single dose of 0.5 mL, repeatable after 15 to 30 minutes if needed. For a 12 kg child this equals 0.12 mL. The adult maximum of 0.5 mL would cause dangerous overdose in a toddler, and steroids and antihistamines are adjuncts only, never first line.
Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.