A 28-year-old patient is brought to the emergency department with sudden onset of shortness of breath, widespread urticaria, and dizziness after eating shellfish. The patient's blood pressure is 80/50 mmHg, and their respiratory rate is 28 breaths per minute. What is the most appropriate initial intervention?
The correct answer is to administer intramuscular epinephrine. In cases of anaphylaxis, epinephrine is the first-line treatment and should be given immediately. It helps to reverse the life-threatening effects of anaphylaxis by constricting blood vessels, relaxing bronchial smooth muscles, and reducing inflammation.
While oxygen therapy and IV fluids are important supportive measures, they are secondary to epinephrine administration. Diphenhydramine (an antihistamine) can help with itching and hives but does not address the life-threatening aspects of anaphylaxis and should not be used as the initial treatment. The rapid onset of symptoms after shellfish exposure, combined with respiratory distress, hypotension, and widespread urticaria, clearly indicates anaphylaxis, requiring immediate epinephrine administration.
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