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Indications & Dosing
- Cardiac Arrest: Asystole/pulseless arrest, pulseless VT/VF
- 1 mg (IV/IO) every 3-5 minutes until return of spontaneous circulation (ROSC)
- 2 to 2.5 mg (ET) every 3 to 5 minutes until IV/IO access established or ROSC
- dilute in 5 to 10 mL NS or sterile water
- Increases coronary perfusion pressure during cardiopulmonary resuscitation
- Bronchospasm – reversible airway disease due to Asthma or COPD
- Anaphylaxis and other systemic allergic reactions; epinephrine is the agent of choice.
- 0.2 to 0.5 mg IM every 5 to 15 minutes in the absence of clinical improvement
- Start a dirty epi drip (see below)
- Cardiogenic shock, especially if a vasodilator is added.
- Bradycardia (symptomatic; unresponsive to atropine or pacing)
- 2-10 mcg per minute
- To make a dirty epi drip (great article by Zlatan Coralic, PharmD on ALIEM)
- Take code-cart epinephrine. It doesn’t matter if it is 1:1,000 or 1:10,000!
- Inject full 1 mg into a 1,000 mL normal saline bag (final concentration 1 mcg/mL).
- Run wide open until the patient’s hemodynamics stabilize.
- IV (by central line)
- Endotracheal tube (rapidly absorbed by tracheal mucosa)
- 1:1,000 is equivalent to 1 mg/mL
- 1:10,000 is equivalent to 100 mcg/mL
- Davis’s Canadian Drug Guide for Nurses
- Marino’s ICU Book