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Epinephrine

Cardiac arrest, Anaphylaxis, Septic shock (vasopressor)

Indications

  • Cardiac arrest
  • Anaphylaxis
  • Septic shock (vasopressor)

Adult dosing

  • cardiac arrest: dose: 1; unit: mg; route: IV/IO; interval: q3-5min; fixed: true; anaphylaxis: dose: 0.3; unit: mg; route: IM; site: lateral thigh; fixed: true; drip: dose: 0.1; maxDose: 0.5; unit: mcg/kg/min; route: IV; weightBased: true; titrationTarget: Titrate to MAP ≥65 or clinical response

Pediatric dosing

  • cardiac arrest: dose: 0.01; unit: mg/kg; maxDose: 1; maxDoseAbsolute: true; route: IV/IO; interval: q3-5min; weightBased: true; anaphylaxis: dose: 0.01; unit: mg/kg; maxDose: 0.5; maxDoseAbsolute: true; route: IM lateral thigh; weightBased: true; drip: dose: 0.1; maxDose: 1; unit: mcg/kg/min; route: IV; weightBased: true; titrationTarget: Titrate to MAP ≥65 or clinical response

Clinical pearls

  • Cardiac arrest: 1mg IV/IO q3-5min — no maximum in arrest
  • Anaphylaxis: IM thigh preferred over IV unless in shock
  • Drip: titrate to MAP >65; expect tachycardia

Source and review

  • ACLS Guidelines 2020, AHA. Last reviewed: 2024-11-01