A: Adrenaline

Adrenaline is the key, life saving drug in anaphylaxis.

Alarmingly, in a UK case series of fatal anaphylaxis, one-third received no adrenaline, and of the two-thirds who did, only 14% were given adrenaline pre-arrest. [3]

Not on your shift surely.?

0.5 mg IM is the dose for over 12 years old and, hopefully, the paramedics will have beaten you to it. In which case, repeat if indicated.

Consider IV titrated adrenaline if you are experienced in this after 2 doses of IM adrenaline. This is done by mixing 1mg of adrenaline (1:1000) in 100mls NaCl and starting at a rate of 0.5-1 ml/kg/hr and titrating according to response. See the RCUK refractory guidelines. [1]