In an acute allergic reaction requiring epinephrine, what is the immediate nursing intervention?

• A. Administer epinephrine per protocol.
• B. Delay epinephrine until airway compromise occurs.
• C. Administer antihistamine only.
• D. Do nothing until physician arrives.

Answer: (A)

In an acute allergic reaction with potential anaphylaxis, the priority is to deliver epinephrine immediately according to protocol. Epinephrine acts rapidly to reverse airway edema, relax bronchial smooth muscle, constrict dilated vessels to raise blood pressure, and reduce overall mucosal swelling. This is why the first and best action is to administer the prescribed intramuscular dose—typically into the mid-outer thigh—and repeat if symptoms persist or worsen while ongoing monitoring and readiness for further airway support are maintained.

Antihistamines may help with itching and hives, but they don’t rapidly reverse airway obstruction or hypotension and should not delay epinephrine. Delaying treatment until airway compromise becomes evident or waiting for a physician to arrive can allow the reaction to progress to life-threatening levels, so prompt epinephrine administration is essential.