For epinephrine administration in an EMS anaphylaxis case, which route is recommended?

• A. Intravenous infusion.
• B. Oral administration.
• C. Intramuscular injection in the mid-outer thigh.
• D. Subcutaneous injection in the thigh.

Answer: (C)

Rapid, reliable absorption is essential in anaphylaxis. Injecting epinephrine intramuscularly into the mid-outer thigh (the vastus lateralis) delivers the drug quickly into the bloodstream, producing a faster onset to reverse airway swelling, bronchospasm, and hypotension. The thigh is preferred because it has a large, well‑vascularized muscle and consistent absorption, and it’s easy to access in emergencies.

Oral administration is ineffective in this acute setting due to slow and unreliable absorption. Subcutaneous injection is slower and more variable than intramuscular, which can delay the response. Intravenous infusion carries higher risk and is generally reserved for controlled hospital settings with close monitoring. Therefore, the intramuscular route in the mid-outer thigh is the recommended approach.