A 12 year old girl when playing in the garden accidentally stepped on a hive and was bitten several times. She has numerous wheals on her body and complains of severe itching. What is the single most appropriate management?

The key is A. Oral antihistamine. [Intravenous antihistamines are used as an adjunct to adrenaline in the emergency treatment of anaphylaxis and angioedema. Parenteral antihistamine is not recommended in less severe allergic reaction (other than anaphylaxis)]. Followings are the indications of adrenaline in anaphylaxis:

1. Horseness of voice

2. Wheeze

3. Shortness of breath

4. Shock

5. Stridor

6. Swelling of the tongue and cheek

7. Facial swelling ].