Indication
Anaphylaxis, cardiac arrest, refractory shock, severe asthma.
Preparation
Infusion: 1 mg in 50 mL D5W (20 mcg/mL). Anaphylaxis IM: 0.5 mg (1:1000) IM.
Dilution
1 mg / 50 mL D5W → 20 mcg/mL
Rate
0.05–0.5 mcg/kg/min IV; IM 0.5 mg q5min PRN in anaphylaxis.
Monitoring
- • ECG (arrhythmia)
- • BP
- • Glucose
- • Lactate
Common errors
- • Confusing 1:1000 (IM) vs 1:10 000 (IV) concentrations
- • IV push in non-arrest patient → severe hypertension
Pearls
- • IM thigh in anaphylaxis — fastest absorption
- • Cardiac arrest: 1 mg IV/IO q3–5 min
