Epinephrine (Adrenalin)

 

INDICATIONS:

 

  • Ventricular Fibrillation/Pulseless Ventricular Tachycardia
  • Asystole
  • Pulseless Electrical Activity (PEA)
  • Anaphylaxis
  • Bronchospasm

 

 DOSAGE:

 

  • ADULT:

 

    • Cardiac Arrest:
      • 1 mg 1:10,000 solution IV/IO every 3-5 minutes until ROSC
    • Anaphylactic Shock / Allergic Reaction:
      • ALS: If patient has respiratory distress and other signs of an allergic reaction 0.5 mg 1:1000 solution IM; may repeated every 15 minutes up to three times for a total of 4 doses.
      • Contact Medical Control if patient is
      • hemodynamically unstable, for orders of
      • 1:10,000 solution 0.05 mg to 0.1 mg IV.
      • BLS: See COG 8.3.1 for Epi pen alternative kit and dose.
    • Hypotension:
      • 10-20 mcg (1-2 ml) 1:100,000 q3-5m

 

 

  • PEDIATRIC:

 

    • Cardiac Arrest:
      • 0.01 mg/kg (0.1 mL/kg) 1:10,000 solution IV/IO every 3-5 minutes until ROSC
    • Bradycardia:
      • 0.01 mg/kg (0.1 mL/kg) 1:10,000 solution IV/IO every 3-5 minutes until rhythm changes or physician directs otherwise
    • Anaphylactic Shock / Allergic Reaction:
      • ALS: If patient is under 3 years of age contact Medical Control and request an order of 0.01 mg/kg 1:1,000 solution up to a max of 0.5 mg IM
      • If patient has respiratory distress and other signs of an allergic reaction; may be repeated up to three times every 15 minutes or a total of 4 doses
      • Contact Medical Control if patient is hemodynamically unstable, for orders of 1:10,000 solution 0.3 mg IV
      • BLS: See COG 8.3.1 for Epi pen alternative kit and dose.
    • Hypotension: Consider Push Dose EPI OLMC*

 

 THERAPEUTIC EFFECTS:

 

  • Increased systemic vascular resistance
  • Increased arterial B/P
  • Increased heart rat
  • Increased coronary and cerebral blood flow
  • Increased myocardial contraction
  • Increased myocardial O2 demand
  • Increased automaticity

 

 RELATIVE CONTRAINDICATIONS:

 

  • There are no contraindications to the use of epinephrine in the situation of cardiac arrest.

 

 SIDE EFFECTS:

  • Palpitations
  • Hypertension
  • Dysrhythmias
  • Anxiety
  • Tremors