Drug Reference
Arrest
Epinephrine
Also: Adrenaline
α/β-adrenergic agonist (catecholamine)
IndicationAdultPediatric
Cardiac arrestAdult1 mg IV/IO (1 mg/10 mL) every 3–5 minPeds0.01 mg/kg IV/IO (0.1 mL/kg of 0.1 mg/mL), max 1 mg
Anaphylaxis (IM)Adult0.5 mg IM of 1 mg/mL, anterolateral thigh; repeat q5–15 minPeds0.01 mg/kg IM, max 0.3 mg
Bradycardia / shock infusionAdult2–10 mcg/min (≈ 0.02–0.5 mcg/kg/min), titratePeds0.02–1 mcg/kg/min
NeonatalAdult-Peds0.02 mg/kg IV (0.01–0.03); ET 0.05–0.1 mg/kg
Indications
- Cardiac arrest (all rhythms)
- Anaphylaxis
- Symptomatic bradycardia (infusion)
- Shock / post-arrest hypotension
Contraindications & cautions
- None in cardiac arrest or anaphylaxis
Key pearls
- Non-shockable arrest: give as soon as possible
- Shockable arrest: give after initial defibrillation attempts fail (after the 2nd shock)
- IM, not IV push, for anaphylaxis with a pulse: IV bolus doses cause arrhythmias
- Endotracheal route only if no IV/IO: 2–2.5 mg