If signs of anaphylaxis appear on board and an epinephrine auto-injector is available, what is the recommended action?

• A. Treat as anaphylaxis and call EMS
• B. Take antihistamines and wait for EMS
• C. Ignore and monitor
• D. Position the passenger lying flat with legs elevated

Answer: (A)

Anaphylaxis is a life-threatening emergency where airway swelling and shock can develop rapidly, so the most important step is to administer epinephrine as soon as signs appear. Using an epinephrine auto-injector right away helps narrow the blood vessels, open the airways, and reduce swelling, which can prevent progression to airway failure or cardiac collapse. Because time is critical, delaying epinephrine to wait for EMS or to give other medicines is not advisable. After giving the auto-injector, activate EMS to ensure ongoing monitoring and potential additional treatment, and stay with the passenger to observe breathing and circulation. If symptoms persist or recur and another auto-injector is available, a second dose may be given after the recommended interval. Antihistamines and other interventions may be supportive, but they do not treat the life-threatening aspects quickly enough, so they should not replace epinephrine.