UNCONTROLLED WHEN PRINTED
Introduction
  • 1mg in 1ml (1:1000)
  • A naturally occurring sympathomimetic agent
  • Causes peripheral vasoconstriction
  • Stimulation of cardiac conduction system causes increased contractions
  • Causes bronchodilation and dilation of blood vessels in muscles
  • IV/IO: Onset 30 seconds, peak 3-5 minutes, duration 5-10 minutes
  • IM: Onset 30-90 seconds, peak 5-10 minutes, duration 5-10 minutes

Pharmacology Review

Indications
  • Anaphylaxis
  • Life-threatening asthma
  • Severe croup
  • Cardiac Arrest
  • Post ROSC
Contraindications
  • There are no absolute contraindications for adrenaline
Precautions / Notes
  • Ischaemic Heart Disease
  • Do not walk patient pre/post IM adrenaline administration in anaphylaxis
Management
Cardiac Arrest

Adult:

  • 1mg IV/IO every 3-5 minutes

Paediatric / Newborn:

  • Dilute 1mg adrenaline in 9ml normal saline (1000 mcg in 10mls, 1:10,000)
    10mcg/kg = 0.1ml/kg (1:10000) every 3-5 minutes.
Post ROSC

Dilute 1mg Adrenaline in 9ml normal saline (1000 mcg in 10mls, 1:10,000)

Adult:

  • 50 mcg (0.5ml) every 3-5 min as required to maintain systolic blood pressure >90mmHg

Paediatric:

  • 1mcg/kg every 3-5 min (max bolus 50mcg) to maintain systolic blood pressure > 80 mmHg

Titrate Adrenaline as required, to achieve and / or maintain the SBP requirements as listed above.

Anaphylaxis or life-threatening Asthma

Adult:

  • 0.5mg IM into lateral mid-thigh (0.5ml of 1:1000), repeat every 5 minutes as clinically required

Pregnant Females experiencing anaphylaxis:

  • 0.3mg IM into lateral mid-thigh (0.3ml of 1:1000), repeat every 5 minutes as clinically required

Paediatric:

  • 0.01mg/kg IM into lateral mid-thigh, repeat every 5 minutes as clinically required
Croup

Infants/Paediatric:

  • 5mg in 5mls nebulised once only.
Special Considerations
  • Dysrhythmias
  • Hypertension
  • Pupil dilation
  • Tremor
  • Anxiety
  • Palpitations

References
References
Presentation
1mg in 1mL (1:1000) ampoule
Aderenaline
Colour assist:

Document Control


Directorate
Clinical Services

Responsible Manager
Head of Clinical Services

Date of Issue

Date of Expiry

St John WA © Copyright 2020. All Rights Reserved

Privacy Policy | Copyright Statement & Disclaimer