1. Description
    Increases myocardial and cerbral blood flow during CPR, helps to increase electrical activity in the heart, may enhance defibrillation in V-Fib
  2. Mechanisim of Action
    A potent catecholamine, increases myocardial and cerbral blood flow during CPR, increases cardiac contractile force, heart rate, and automaticity, increases myocardial oxygen demand, epinephrine is only effective when the myocardium is adequatley oxygenated, its effets appear within 90 seconds of administration
  3. Indications
    1:1000-severe, systemic allergic reactions; asthma in persons under 40 years of age; exacerbation of COPD; 1:10,000-fine V-Fib, asystole, Pulseless Electrical Activity
  4. Contrainindications
    None in the emergency setting
  5. Precautions
    Should not be added to solutions containg sodium bicarbonate (deactivated by alkaline solutions), may precipitate angina or MI in susceptible pts, anxiety, palpitations, tachycardia, and headache are common side effects.
  6. Dosage and Solutions
    • 1:1000-the initial adult dose os 0.3-0.5mg IM
    • 1:10,000-for cardiac patients, administer in doses of 1.0 milligram IVP. Each IV dose is followed by 10-20ml flush of NS to ensure delivery of drug to central circulation. Repeat every 3-5 minutes until pt is resuscitation is complete.
    • Endotracheal-increase dose to 2.0-2.5mg. Drug must be diluted in at least 10ml NS prior to ET administration
    • Peds
    • Cardiac arrest-Epinephrine 1:10,000 0.01mg/kg IV/IO q 5 min or
    • Epinepherine 1:1000 0.1 mg/kg ET q 3-5 min
    • Anaphylaxis- Epinephrine 1:1000 0.01mg/kgf IM, max dose is 0.3mg
    • Croup- Epinephrine 1:1000 diluted to 2.5-3 cc saline flush may repeat up to 3 doses.
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