How do I prepare a 1 in 10,000 solution of epinephrine (adrenaline)?

From the Guidelines

To prepare 1 in 10000 adrenaline, dilute 1 mL of 1:1000 adrenaline (1 mg/mL) with 99 mL of normal saline (0.9% sodium chloride) to make a total volume of 100 mL. This yields a 1:10,000 concentration (0.01 mg/mL or 10 mcg/mL) as per the guidelines for anaphylaxis management 1. The preparation of adrenaline solutions is critical in clinical settings, particularly for the treatment of anaphylaxis, where precise dosing is essential to minimize adverse effects while effectively managing the condition. Key considerations include:

• Using sterile technique to prepare the solution
• Labeling the syringe clearly with the drug name, concentration, and preparation time
• Administering the solution in a controlled environment with monitoring available, especially when used intravenously due to the risk of potentially lethal arrhythmias 1. The most recent and highest quality studies emphasize the importance of careful preparation and administration of adrenaline solutions in clinical practice, prioritizing patient safety and effective management of anaphylaxis 1.

From the Research

Preparing 1 in 10000 Adrenaline Solution

To prepare a 1 in 10000 adrenaline solution, the following steps can be taken:

• The standard dose of adrenaline for an adult is 300-600 µg 2
• However, the provided studies do not give specific instructions on how to prepare a 1 in 10000 adrenaline solution
• In medical settings, adrenaline is often administered via intramuscular injection with an autoinjector or intravenously in emergency situations 2, 3, 4, 5, 6
• The preparation of adrenaline solutions may vary depending on the specific medical context and the equipment available

Important Considerations

• Adrenaline administration can have serious cardiac adverse effects, especially when given intravenously 2, 3
• The use of an autoinjector should be specially practiced in advance to ensure proper administration 2
• In cases of anaphylaxis-induced cardiac arrest, a more aggressive approach, including intravenous adrenaline infusion, may be necessary 4
• There is variation across international guidelines for adrenaline dosing and frequency in the treatment of anaphylaxis 5

Administration Routes and Doses

• Intramuscular injection with an autoinjector is the method of choice for administering adrenaline in non-intensive care settings 2
• The dose to be administered is 300-600 µg for an adult or 10 µg/kg for a child 2
• In cases of cardiac arrest, epinephrine 1 mg may be administered as soon as feasible 6