Cgabryszek: Created page with "'''MECHANISM OF ACTION:''' Stimulates both Alpha– and Beta– Adrenergic receptors; causing bronchodilation, cardiac stimulation, and peripheral vasoconstriction. '''INDICATIONS:''' # Persistent hypotension with symptoms of hypo-perfusion, not responsive to IV fluids. # Severe anaphylaxis or asthma. '''CONTRAINDICATIONS:''' # None during cardiac arrest profound anaphylaxis or profound hypotension '''PRECAUTIONS:''' # May precipitate with sodium bicarbonate if..."

2022-04-04T03:10:13Z

Created page with "'''MECHANISM OF ACTION:''' Stimulates both Alpha– and Beta– Adrenergic receptors; causing bronchodilation, cardiac stimulation, and peripheral vasoconstriction. '''INDICATIONS:''' # Persistent hypotension with symptoms of hypo-perfusion, not responsive to IV fluids. # Severe anaphylaxis or asthma. '''CONTRAINDICATIONS:''' # None during cardiac arrest profound anaphylaxis or profound hypotension '''PRECAUTIONS:''' # May precipitate with sodium bicarbonate if..."

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'''MECHANISM OF ACTION:''' Stimulates both Alpha– and Beta– Adrenergic receptors; causing bronchodilation, cardiac stimulation, and peripheral vasoconstriction.

'''INDICATIONS:'''

# Persistent hypotension with symptoms of hypo-perfusion, not responsive to IV fluids.
# Severe anaphylaxis or asthma.

'''CONTRAINDICATIONS:'''

# None during cardiac arrest profound anaphylaxis or profound hypotension

'''PRECAUTIONS:'''

# May precipitate with sodium bicarbonate if tubing is not flushed between drugs.

'''ADVERSE REACTIONS/SIDE EFFECTS:'''

# Nervousness, restlessness, and tremors
# Headache and HTN
# Arrhythmias and angina
# May induce or exacerbate ventricular ectopy, especially in patients receiving digitalis.

{| class="wikitable"
|'''Paramedic'''
|}
There are 2 options for administering epinephrine for cardiopulmonary support:

# Epinephrine infusion.
# Push Dose Epinephrine.

'''Epinephrine infusion.''' ''To prepare:''

# Take a 1L bag of NS and waste 750mL, so that you are left with 250ml of NS.
# Mix 2mg of '''Epi 1:1,000''' in 250mL of NS using a 60 drop micro set.
## This concentration is '''[8mcg/mL.]'''
## Administer '''2-10mcg/min''' '''IV/IO''' to maintain cardiopulmonary support.
### Titrate to maintain SBP > 90mmHg and/or adequate respiratory status.

'''Push Dose Epinephrine.''' ''To prepare:''

# Take a 10mL NS flush and waste 1mL of NS, so that you are left with 9mL.
# With this syringe of 9mL of NS, draw up 1mL of '''Epi 1:10,000''' from the prefilled syringe.
## '''You now have 10mL of Epi with a concentration of [10mcg/mL.]'''
# Administer '''0.5 – 2mL IV/IO''' every 2-5 minutes (5-20mcg) to maintain cardiopulmonary support.
## Titrate to maintain SBP > 90mmHg and/or adequate respiratory status.
# Onset: 1 minute
# Duration: 5-10 minutes.

'''PEDIATRIC CONSIDERATIONS:'''

# For Cardiac Arrest:
## Refer to the weight-based resuscitation tape and administer one dose of 0.01 mg/kg IV/IO push every 3-5 minutes as indicated.
# For Cardiopulmonary instability: (anaphylaxis, severe shock, severe asthma) with concern for imminent respiratory or cardiac arrest:
## Administer Epi Infusion or Push Dose Epinephrine 0.1-0.5 mcg/kg/min titrated to maintain SBP > 90mmHg.
## Administration of “Push-Dose Epi” in quantities of < 0.5mLfor a single dose is likely to be difficult. Thus administration of 0.5mL as a minimum dose is reasonable.

'''SPECIAL NOTES:'''

'''1:10,000''' is the highest epinephrine concentration appropriate for direct intravascular administration.

5-9 PUSH DOSE EPINEPHRINE (PARAMEDIC ONLY) - Revision history