In a 4-year-old child with anaphylaxis after a wasp sting, what initial strength of adrenaline should be given intramuscularly, with repeat dosing as required?

In a 4-year-old child with anaphylaxis after a wasp sting, what initial strength of adrenaline should be given intramuscularly, with repeat dosing as required?

• A. 300 micrograms, then repeated after 5-15 minutes as required
• B. 15 micrograms, repeated after 5-15 minutes as required
• C. 150 micrograms, then repeated after 5-15 minutes as required
• D. 1 milligram, repeated after 5-15 minutes as required

Answer: (C)

Adrenaline dosing in a child with anaphylaxis is weight-based and given intramuscularly, with repeat dosing every 5–15 minutes as needed. The standard starting amount is 0.01 mg per kg. For a 4-year-old weighing about 15 kg, that comes to roughly 150 micrograms per injection. This dose quickly helps reverse airway swelling, bronchospasm, and shock, and can be safely repeated if symptoms persist. The other options don’t fit the typical weight-based approach for a child of this size: 15 micrograms is too small to control a systemic anaphylactic reaction; 1 milligram is far too high for a young child and could cause significant adverse effects; 300 micrograms could be used in heavier children but isn’t the usual starting dose for a small 4-year-old.

Adrenaline dosing in a child with anaphylaxis is weight-based and given intramuscularly, with repeat dosing every 5–15 minutes as needed. The standard starting amount is 0.01 mg per kg. For a 4-year-old weighing about 15 kg, that comes to roughly 150 micrograms per injection. This dose quickly helps reverse airway swelling, bronchospasm, and shock, and can be safely repeated if symptoms persist. The other options don’t fit the typical weight-based approach for a child of this size: 15 micrograms is too small to control a systemic anaphylactic reaction; 1 milligram is far too high for a young child and could cause significant adverse effects; 300 micrograms could be used in heavier children but isn’t the usual starting dose for a small 4-year-old.