Class:
Sympathomemetic

Action:
Alpha & Beta adrenergic agonist, Bronchodilator

Indications:
Cardiac arrest
Anaphylaxis
Asthma / Bronchospasm
Pediatric / Neonatal bradycardia
Septic shock
Shock secondary to Beta blocker/Calcium channel blocker overdose
Croup/Subglottic Edema

Precautions:
Hypersensitivity
Coronary insufficiency
Hypertension
Chronic COPD with degenerative heart disease

Adult Dosing:

• Cardiac Arrest: 1mg (10ml) 1:10,000 IV/IO q 3-5 min
• Asthma/Bronchospasm: 0.3mg (0.3ml) deep IM of 1:1000
• Allergic Reaction/Anaphylaxis: 0.3mg (0.3ml) IM mid-lateral thigh of 1:1000, repeat if needed every 5 minutes x 3 then contact medical control
• Anaphylaxis with Cardiovascular Collapse:  1mg in 1000ml bag of NS run wide open and then titrate to effect
• Refractory Hypotension: 0.1mg (1ml) of 1:10,000 slow IVP, then mix 4 mcg/ml concentration (Dilute 1mg in 250ml bag of D5W or NS gives 4mcg/ml) and start infusion at 1 mcg/min (0.25 ml)/min; titrate to effect
• Bradycardia: 1-10mcg/min IV; titrate to effect

CLICK HERE FOR THE EPI INFUSION CHART 7-25-16

Pediatric Dosing: (Use Broselow tape for dosing)

• Bradycardia: 0.01 mg (0.1 ml)/kg IV or IO of 1:10,000
• Asthma/Bronchospasm: 0.01 mg (0.01 ml)/kg up to 0.3mg (0.3 ml) IM mid-lateral thigh of 1:1000, repeat if needed every 5 minutes x 3 then contact medical control
• Allergic Reaction/Anaphylaxis: 0.01 mg (0.01 ml)/kg up to 0.3mg (0.3 ml) IM mid-lateral thigh of 1:1000, repeat if needed every 5 minutes x 3 then contact medical control
• Cardiac Arrest:  0.01 mg (0.1 ml)/kg IV or IO of 1:10,000 repeat q 3-5 min
• Croup/Subglottic Edema:  5 mL of 1:1,000 epinephrine x 1 via nebulizer at 6-8 LPM to create a fine mist and administer over 15 minutes