Adrenaline/Epinephrine

Indications & Dose:

Cardiopulmonary resuscitation 

• BY INTRAVENOUS INJECTION

Adult: 1 mg every 3–5 minutes as required, a 1 in 10000 (100 micrograms/mL) solution is recommended

Acute hypotension

•  BY CONTINUOUS INTRAVENOUS INFUSION

Neonate: Initially 100 nanograms/kg/minute, adjusted according to response, higher doses up to 1.5 micrograms/kg/minute have been used in acute hypotension.

Child: Initially 100 nanograms/kg/minute, adjusted according to response, higher doses up to 1.5 micrograms/kg/minute have been used in acute hypotension

Emergency treatment of acute anaphylaxis (under expert supervision)

Angioedema (if laryngeal oedema is present) (under expert supervision) 

• BY INTRAMUSCULAR INJECTION

Child 1 month–5 years: 150 micrograms, doses may be repeated several times if necessary at 5 minute intervals according to blood pressure, pulse, and respiratory function, suitable syringe to be used for measuring small volume; injected preferably into the anterolateral aspect of the middle third of the thigh

Child 6–11 years: 300 micrograms, doses may be repeated several times if necessary at 5 minute intervals according to blood pressure, pulse, and respiratory function, to be injected preferably into the anterolateral aspect of the middle third of the thigh

Child 12–17 years: 500 micrograms, to be injected preferably into the anterolateral aspect of the middle third of the thigh, doses may be repeated several times if necessary at 5 minute intervals according to blood pressure, pulse, and respiratory function, 300 micrograms (0.3 mL) to be administered if child small or prepubertal Adult: 500 micrograms, to be injected preferably into the anterolateral aspect of the middle third of the thigh, doses may be repeated several times if necessary at 5 minute intervals according to blood pressure, pulse, and respiratory function

Acute anaphylaxis when there is doubt as to the adequacy of the circulation (specialist use only) | Angioedema (if laryngeal oedema is present) (specialist use only)

• BY SLOW INTRAVENOUS INJECTION

Adult: 50 micrograms, using 0.5mL of the dilute 1 in 10 000 adrenaline injection, dose to be repeated according to response, if multiple doses required, adrenaline should be given as a slow intravenous infusion stopping when a response has been obtained Control of bradycardia in patients with arrhythmias after myocardial infarction, if there is a risk of asystole, or if the patient is unstable and has failed to respond to atropine

• BY INTRAVENOUS INFUSION

Adult: 2–10 micrograms/minute, adjusted according to response

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