From the Guidelines
The dosage concentration for a push dose of epinephrine (adrenaline) is typically 1:10,000.
Key Points
- The recommended initial resuscitation dosage in adults is 1 to 3 mg (1:10,000 dilution) slowly administered intravenously over 3 minutes 1.
- For children, the recommended initial dosage is 0.01 mg/kg (0.1 mL/kg of a 1:10,000 solution up to a maximum of 0.3 mg) repeated every 3 to 5 minutes for ongoing arrest 1.
- An alternative epinephrine infusion protocol has been suggested for adults with anaphylaxis, using a 1:100,000 solution of epinephrine (1 mg [1 mL] in 100 mL of saline) intravenously by means of infusion pump at an initial rate of 30 to 100 mL/h (5-15 mg/min) 1.
- It's essential to note that the use of intravenous epinephrine should be done with caution and ideally with continuous hemodynamic monitoring, especially in patients with cardiac conditions or those who have failed to respond to initial treatments 1.
Administration Considerations
- The dosage and administration of epinephrine may vary depending on the patient's condition, age, and response to treatment.
- It's crucial to follow established guidelines and consult with a healthcare professional for specific guidance on administering epinephrine in emergency situations.
- The risk of potentially lethal arrhythmias associated with intravenous epinephrine administration should be carefully considered, especially in patients with pre-existing cardiac conditions 1.
From the Research
Dosage Concentration for Push Dose of Epinephrine
- The dosage concentration for a push dose of epinephrine is not explicitly stated in the provided studies as a standardized concentration for all scenarios.
- However, according to the study 2, a push dose of epinephrine used in the management of hypotension during critical care transport involves administering 10-20 µg of 1:100,000 epinephrine intravenously every 2 min.
- This translates to a specific concentration and dosage regimen rather than a one-size-fits-all concentration for push dosing.
- Other studies, such as 3, 4, and 5, discuss various aspects of epinephrine dosing, including standard doses, escalating dosage concepts, and optimal weight-based dosing, but they do not specifically address the concentration for a push dose in the context provided by 2.
- The study 6 focuses on epinephrine degradation with exposure to excessive heat or cold, which does not directly relate to the dosage concentration for push dosing.
- The optimal weight-based epinephrine dose for return-of-spontaneous-circulation (ROSC) after a single bolus among patients with a low likelihood of survival, as investigated in 5, suggests an optimal dose of 0.013 mg/kg, but this is in a different context and does not specify a push dose concentration.