In a peanut-allergic child who develops signs of anaphylaxis, which action should be taken first?

• A. Administer the epinephrine autoinjector
• B. Prepare for rapid transport
• C. Administer diphenhydramine
• D. Administer oxygen by NRB

Answer: (A)

In anaphylaxis, the immediate priority is to reverse airway swelling and shock with epinephrine. Epinephrine acts quickly to reduce throat and airway edema, relax bronchospasm, and tighten blood vessels to raise blood pressure, which can prevent rapid deterioration and potential failure of breathing. Because of its fast, life-saving action, administer the epinephrine autoinjector right away rather than waiting for other treatments. After giving epinephrine, call for advanced care and prepare for rapid transport. Oxygen can be given to support breathing, and diphenhydramine may be used later for symptoms like itching, but neither replaces the need for prompt epinephrine in anaphylaxis.