Epinephrine, Pediatric Dosages

Pediatric:

Anaphylaxis:

Epinephrine 1:1,000:

0.01 mg/kg (maximum dose 0.5 mg) IM to lateral thigh.
Push Dose Epinephrine (IV/IO): 

Dilute 0.1mg (1ml) of Epi 1:10,000 in 9cc of normal saline.

Administer 1mcg/kg (0.1ml/kg) IV/IO maximum single dose of 5mcg.  Repeat every 3-5 minutes. 

Cardiac Arrest:

Epinephrine 1:10,000 – 0.01 mg/kg, IV or IO.

Asthma:

Epinephrine 1:1,000 0.01 mg/kg IM to lateral thigh (maximum single dose 0.5 mg).

May repeat in 20 minutes.

Severe Croup:

Nebulize 5 cc Epinephrine 1:1000 via SVN without dilution. Do not repeat within 60 minutes.

Severe Bradycardia and/or Hypotensive Shock State Refractory to fluid resuscitation:

(May consider Push Dose Epinephrine or an Epinephrine Drip)

Dilute 1 mg Epinephrine in 1000 cc NS = 1mcg/ml.

Initial infusion rate of 1 mcg/minute, titrated to the desired effect.
Pediatric dose range: 0.1-1 mcg/kg/minute.

Push Dose Epinephrine (IV/IO) – Dilute (0.1mg) 1 ml of epinephrine 1:10,000 (1mg/10ml) with 9ml of normal saline.  Administer 1mcg/kg (0.1ml/kg) IV/IO.  Maximum single dose of 5mcg (0.5ml), repeat every 3-5 minutes. 

Complete NCEMS Epinephrine Protocol