GuidelinesOther guideline
Infusion: Adrenaline
Adrenaline Infusion
| Trade names: | Presentation and strength: |
| Adrenaline | 1mg/1ml ampoules |
| Cautions: see SAMF | |
| Be very cautious when flushing IV lines and bolusing even dilute adrenaline infusions. Very small boluses (inadvertently ‘bumping’ the syringe plunger) can precipitate severe tachycardia, hypertension, myocardial ischaemia/infarction and cardiac failure, even in the very young and very fit. | |
| Loading dose: | |
| Adult: IV 0.1 to 1mg for cardiac arrest. SC: 0.1 to 0.5mg. | Paediatric: Cardiac arrest: IV 0.1ml/kg of 1:10 000. Anaphylaxis: IV: 0.05 to 0.1ml/kg 1: 10 000 or IM 0.01mg/kg (0.01ml/kg of 1: 1000). Repeat if required. |
| Commonly for 70kg adult: IV: 1mg SC: 0.5mg | Neonatal: As above. |
| Constant infusion: | |
| Adult dosage range: 0.01 to 1mcg/kg/min titrated to response. | Paediatric dosage range: 0.05 to 1mcg/kg/min as below: |
| Neonatal dosage range: As above. | |
| Regime for 70kg adult: | Regime for paediatrics: |
| Mixture: Mix 1mg/50ml or 4mg/200ml Saline = 20mcg/ml (Also 5mg/200ml Saline = 25mcg/ml) | Mixture: 0.3mg/kg in 50ml total volume. |
| Rate: 0.01mcg/kg/min = 2.1ml/hr 1mcg/kg/min = 200ml/hr. Usually start at 5 to 10ml/hr. | Rate: 0.5 to 10ml/hr. |
| Alternative adult regime (1): | Alternative adult regime (2): |
| Mixture: Double strength = 2mg/50ml or 8mg/200ml. (or 10mg/200ml) | Mixture: Quadruple strength = 4mg/50ml or 16mg/200ml. |
| Rate: Maximum rate 100ml/hr. (50ml/hr) | Rate: Maximum rate 50ml/hr. |
| Additional notes | |
| Lower doses tend to produce predominantly beta effects, while higher doses tend to produce predominantly alpha effects. | |
| Other: | |
| Maximum rates quoted above are very high and seldom, if ever, necessary. Usual dose is seldom more than 20ml/hr (0.1mcg/kg/min) single strength solution. | |