A 15 mo girl with a known allergy to peanuts was brought into the ED after eating a cookie at restaurant. She vomited once prior to the arrival.
She shows T 37ÂșC HR 145 RR 36 BP 65/35 SpO2 99 % on RA.
She is sleepy but arousable. There is no obvious urticaria or angioedema. There is no wheeze on auscultation. Her heart sounds are normal, and she has a capillary refill time of 2-3 seconds
What is the most appropriate next step in management?
- 20 ml/kg bolus IV normal saline
- 0.01 mg/kg (1mg/ml) IM epinephrine
- 0.01 mg/kg (1mg/ml) IV epinephrine
- Ondansetron followed by PO rehydration
This question appears in Med-Challenger Pediatric Emergency Medicine Review 3rd Edition with CME.
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