A 25-year-old woman presents to the ED with acute onset of wheeze, urticarial rash, facial swelling, and difficulty breathing. She ate a meal containing shellfish 20 minutes ago. Her oxygen saturations are 89% and she is becoming increasingly distressed. How would you manage this?
- Anaphylaxis is a clinical diagnosis: acute onset of skin/mucosal changes plus life-threatening airway, breathing, or circulatory compromise
- First-line treatment: IM adrenaline 0.5mg (1:1000 / 1mg/mL) into the anterolateral thigh - repeat at 5-minute intervals if no improvement
- Position: lie flat with legs elevated (unless breathing difficulty predominates, in which case sit upright)
- Remove the trigger if possible
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How to approach this Emergency Medicine interview question
This clinical question is common in Emergency Medicine NHS interviews because it reveals how you think under interview pressure, not just what facts you can recall. Use "A 25-year-old woman presents to the ED with acute onset of wheeze, urticarial rash,..." as the anchor for a concise answer with a clear opening, a clinical or professional structure, and a reflective close.
What the panel is testing
A strong clinical answer sounds safe before it sounds clever. Use a structure such as initial assessment, immediate management, differential diagnosis, escalation, and reassessment. Mention guidelines only where they help the decision in front of you. For emergency medicine, keep the answer time-aware. Panels expect prioritisation, early senior involvement, concise handover, and awareness of department flow without losing sight of the individual patient.
- Start with immediate safety, ABCDE assessment, senior support, and escalation thresholds.
- Name the likely diagnoses or risks, but show how you would keep reassessing as new information arrives.
- Close with documentation, handover, follow-up, and patient or family communication where relevant.
How to structure your answer
For a clinical prompt, aim for a short opening sentence, then two or three evidence-led points, then a final reflection. If you use STAR, keep the result and reflection as strong as the situation. If it is a clinical scenario, say what you would do now, what you would do next, and how you would keep the patient safe while help is coming.
- Open by naming the main issue in the question.
- Give a structured response rather than a memorised script.
- End with escalation, documentation, learning, or follow-up.
Common mistakes to avoid
The weakest answers usually stay too vague, ignore the specific role, or miss the safety issue hidden in the question. Do not use this page to memorise a perfect paragraph. Use it to rehearse the shape of a safe answer, then adapt it to your own experience and the post you are applying for.
- Anaphylaxis is a clinical diagnosis: acute onset of skin/mucosal changes plus life-threatening airway, breathing, or circulatory compromise
- First-line treatment: IM adrenaline 0.5mg (1:1000 / 1mg/mL) into the anterolateral thigh - repeat at 5-minute intervals if no improvement
- Position: lie flat with legs elevated (unless breathing difficulty predominates, in which case sit upright)