UNCONTROLLED WHEN PRINTED
Introduction
- Presentation:
- 1 mg/1 mL (1:1000) ampoule
- 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, half-life 5 minutes, duration 5-10 minutes
- IM: Onset 60 seconds, half-life 5 minutes, duration 5-10 minutes
Indications
- Anaphylaxis
- Life-threatening asthma
- Cardiac Arrest
- Post-ROSC
- Severe croup
Contraindications
- There are no absolute contraindications to adrenaline
Precautions / Notes
- Ischaemic Heart Disease
- Hypertension
- Hypovolaemia
- Do not walk patient pre or post IM adrenaline administration in anaphylaxis - usually a minimum of 1 hour after 1 dose of Adrenaline and 4 hours if more than 1 dose of Adrenaline given
- If given IV into a peripheral vein, follow each dose with a sodium chloride flush
Management
Cardiac Arrest
Adult:
- 1 mg IV/IO, repeat every 3-5 minutes as clinically indicated
Paediatric / Newborn:
- Dilute 1 mL of 1:1000 adrenaline solution with 9 mL sodium chloride 0.9% to produce 1000 microg in 10 mL (1:10,000)
- 10 microg/kg = 0.1 mL/kg of 1:10,000 adrenaline solution IV/IO, repeat every 3-5 minutes as clinically indicated. Maximum bolus dose 1mg (10mL of 1:10,000 adrenaline solution).
Post-ROSC
Dilute 1 mL of 1:1000 adrenaline solution with 9 mL sodium chloride 0.9% to produce 1000 microg in 10 mL (1:10,000)
Adult:
- 50 microg (0.5 mL) every 3-5 min as required to maintain systolic blood pressure >100 mmHg
Paediatric:
- 1 microg/kg every 3-5 min (maximum bolus 50 microg (0.5 mL)) 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:
- 0.5 mg IM into lateral mid-thigh (0.5 mL of 1:1000), repeat every 5 minutes as clinically required
Paediatric > 1 month:
- 10 microg/kg IM into lateral mid-thigh (0.01 mL of 1:1000) (maximum single dose = 0.5 mg or 0.5 mL), repeat every 5 minutes as clinically required
Croup
Infants (>1 month) / Paediatric:
- Nebulise 5 mg (5 mL of 1:1000) undiluted, as a single dose
Special Considerations
- Tachyarrhythmias, palpitations
- Hypertension
- Pupil dilation
- Tremor
- Anxiety
References
References
Presentation
1 mg/1 mL (1:1000) ampoule
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