What is the recommended route for pediatric epinephrine in anaphylaxis?

• A. Intravenous
• B. Intramuscular
• C. Subcutaneous
• D. Inhaled

Answer: (B)

In pediatric anaphylaxis, epinephrine is given intramuscularly because this route provides rapid, reliable absorption that quickly reverses airway swelling, bronchospasm, and hypotension. The standard pediatric dose is 0.01 mg/kg of a 1:1000 solution, up to a maximum single dose of 0.3 mg, injected into the anterolateral thigh (vastus lateralis). For example, a 20 kg child would receive 0.2 mg IM. The intramuscular route is preferred over subcutaneous because absorption can be slower and less predictable in children; intravenous administration carries higher risk of severe blood pressure and heart rhythm disturbances and is typically reserved for hospital settings with careful monitoring. Inhaled epinephrine is not suitable for systemic anaphylaxis. If symptoms persist, dose can be repeated at 5–15 minute intervals while awaiting further care.