Epinephrine (Adrenalin)

 

INDICATIONS:

 

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

 

ADMINISTRATION:

 

  • SQ, IV, ET, IO
  • MAY GIVE CONTINUOUS IV INFUSION ONLY WITH DIRECT MEDICAL ORDER

 

 DOSAGE:

  ADULT:

 

Cardiac Arrest:

 

  • 1 mg (1:10,000) IV/IO every 3-5 minutes until ROSC

 

Anaphylactic Shock / Allergic Reaction:

 

  • If patient has respiratory distress and other signs of an allergic reaction 0.5 mg (1:1,000) IM. This may be repeated every 15 minutes up to 3 times for a total of 4 doses.

 

Contact Medical Control:

 

  • If patient is hemodynamically unstable for order of Epi 1:10,000 solution 0.5mg IV.

 

Hypotension:

 

  • 10-20 mcg (1-2 mL) 1:100,000 q 3-5 minutes

 

PEDIATRIC:

 

  • Cardiac Arrest:

 

  • 0.01mg/kg (0.1ml/kg) 1:10,000 solution IV/IO every 3-5 minutes until rhythm changes or physician directs otherwise.

 

Bradycardia:

 

  • 0.01mg/kg (0.1ml/kg) 1:10,000 solution IV/IO every 3-5 minutes until rhythm changes or physician directs otherwise

 

Anaphylactic Shock/Allergic Reaction

 

  • If patient under 3 years of age contact Medical Control 0.01 mg/kg (1:1000) up to a max of 0.5 mg IM

 

  • If patient has respiratory distress and other signs of an allergic reaction. This may be repeated up to three times every 15 minutes or a total of 4 doses.

 

Contact Medical Control:

 

  • if patient is hemodynamically unstable and request order of Epi 1:10,000 solution up to a maximum of 0.3mg IV

 

 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

 

 SPECIAL NOTES / RESTRICTIONS:

 

  • Can be inactivated by alkaline solutions
  • Will increase myocardial oxygen demand; provide patient with high-flow oxygen
  • MAY GIVE CONTINUOUS IV INFUSION ONLY WITH DIRECT MEDICAL ORDER
  • **Any dose above 0.5 mg may be administered ONLY WITH DIRECT MEDICAL ORDER