Which statement about oxygen therapy is true in the management of anaphylaxis?

Which statement about oxygen therapy is true in the management of anaphylaxis?

• A. Oxygen delivered via nasal cannula at 4 L/min is sufficient to maximize oxygenation.
• B. Oxygen delivered via a nonrebreather mask to achieve FiO2 close to 100% is recommended.
• C. Oxygen is not indicated in anaphylaxis.
• D. Oxygen should be avoided if epinephrine is given.

Answer: (B)

In anaphylaxis, keeping oxygen levels up is crucial because airway swelling and bronchospasm can rapidly impair gas exchange. The best choice is delivering high FiO2 with a nonrebreather mask, because when the mask fits well and flow is high (typically 10–15 L/min), it can deliver close to 100% oxygen. A nasal cannula at 4 L/min provides a much lower FiO2 and may not meet the patient’s oxygen needs during severe airway involvement. Oxygen is indicated in this situation to prevent hypoxia and support tissue oxygen delivery, and its use is not negated by giving epinephrine. Monitor and maintain adequate oxygenation (often aiming for SpO2 in the 94%+ range) while epinephrine is administered and other treatments are given.

In anaphylaxis, keeping oxygen levels up is crucial because airway swelling and bronchospasm can rapidly impair gas exchange. The best choice is delivering high FiO2 with a nonrebreather mask, because when the mask fits well and flow is high (typically 10–15 L/min), it can deliver close to 100% oxygen. A nasal cannula at 4 L/min provides a much lower FiO2 and may not meet the patient’s oxygen needs during severe airway involvement. Oxygen is indicated in this situation to prevent hypoxia and support tissue oxygen delivery, and its use is not negated by giving epinephrine. Monitor and maintain adequate oxygenation (often aiming for SpO2 in the 94%+ range) while epinephrine is administered and other treatments are given.