NREMT Emergency Medical Technician (EMT) Cognitive ExamAirway, Respiration & VentilationHard
A 24-year-old male is experiencing a severe allergic reaction after being stung by a bee. He is conscious but anxious, with widespread urticaria, facial edema, and audible stridor. His blood pressure is 90/60 mmHg, heart rate 120 bpm, and respiratory rate 28 bpm. What is the most immediate priority for this patient?
- AAdminister epinephrine via auto-injector.
- BAssess distal pulses and skin temperature.
- CApply a non-rebreather mask at 15 L/min.
- DInitiate rapid transport to the nearest emergency department.
Show answer & explanationAnswer & explanation
Correct answer: A. Administer epinephrine via auto-injector.
The patient is experiencing anaphylaxis with signs of airway compromise (stridor, facial edema) and circulatory shock (hypotension, tachycardia). Epinephrine is the definitive treatment for anaphylaxis as it addresses both bronchoconstriction and vasodilation, making it the most immediate life-saving intervention.
Why the other options are wrong
- B. Assessing distal pulses and skin temperature is part of assessment but is not the most immediate priority when life-threatening airway and circulatory compromise are present.
- C. While oxygen is important, it will not resolve the underlying bronchoconstriction or vasodilation causing the stridor and hypotension. Epinephrine is more critical.
- D. Transport is necessary, but delaying epinephrine administration for transport alone would be inappropriate given the severity of the reaction.
Anaphylaxis Management
Anaphylaxis is a severe, life-threatening systemic allergic reaction that can cause rapid airway compromise and circulatory shock. Prompt recognition and treatment are critical.
- Key signs include widespread urticaria, angioedema, respiratory distress (wheezing, stridor), and hypotension.
- Epinephrine is the primary treatment, reversing bronchospasm and vasoconstriction.
- Airway management, oxygen, and fluid resuscitation are also important supportive measures.
Memory trick: Epi first, then Airway and Oxygen, for the allergic reaction's big commotion.