Epinephrine 1:10,000

Indications:

• Cardiac arrest
• Anaphylaxis unresponsive to other treatment
• Pediatric bradycardia unresponsive to other treatment

Contraindications: None

Precautions:

CPR:

• None

Anaphylaxis:

• Monitor ECG closely.
• Patients on beta-blockers may need glucagon or higher doses of epinephrine.
• Do not mix with sodium bicarbonate; flush tubing well between drugs.

Side Effects:

CPR:

• None

Anaphylaxis:

• Tachycardia
• Ventricular arrhythmias
• Headache
• Flushing
• Nausea/vomiting
• Chest Pain
  

Adult Dose:

Standing order:
Cardiac arrest:

• 1mg IV or IO rapid push every 3 – 5 minutes

Anaphylaxis:

• 0.1 mg – 0.2 mg slow push (over 1 minute)

Pediatric Dose:

Standing order:
Cardiac arrest:

• 0.01 mg/kg (0.1 mL/kg) rapid push every 3 - 5 minutes

Anaphylaxis with cardiovascular collapse unresponsive to other measures:

• 0.01 mg/kg slow push (0.1 mL/kg) (maximum dose 0.3 mg)

Route: IV or IO push

Drug Action:

Alpha effects produce peripheral vasoconstriction which:

• Increases coronary and cerebral perfusion
• Increases blood pressure in anaphylaxis

Beta 1 effects:

• Increases heart rate
• Improves force of ventricular contractions

Beta 2 effects:

• Bronchodilation

Class: Sympathomimetic

Onset: 1 minute – 2 minutes

Duration: 5 minutes – 10 minutes