Adrenaline (Anaphylaxis Protocol)

eMC (Adrenaline (Epinephrine) 1 mg/ml (1:1000) solution for injection, ampoule). To be administered by a trained healthcare professional. The IM route is recommended by the EU Resuscitation Council as the most appropriate for most individuals who have to give adrenaline to treat an anaphylactic reaction. Monitor the patient as soon as possible (pulse, blood pressure, ECG, pulse oximetry) to assess the response. Intravenous administration of adrenaline for anaphylaxis requires a 1:10,000 (0.1 mg/ml) solution — if the 0.1 mg/ml injection is not available, the 1 mg/ml (1:1000) solution must be diluted to 0.1 mg/ml before IV use; the IV route must be used with extreme caution and is best reserved for specialists familiar with IV adrenaline (generally more appropriate in the ICU or Emergency Department setting). Elderly: no specific dosage regime, but use with great caution as they may be more susceptible to cardiovascular side effects. PAEDIATRIC (SPC age bands, IM, 1 mg/ml (1:1000) solution): over 12 years — 0.5 mg (0.5 ml), or 0.3 mg (0.3 ml) if the child is small or pre-pubertal; 6–12 years — 0.3 mg (0.3 ml); 6 months–6 years — 0.15 mg (0.15 ml); under 6 months — 0.01 mg/kg (0.01 ml/kg). If necessary these doses may be repeated several times at 5–15 minute intervals according to blood pressure, pulse and respiratory function; a small volume syringe should be used. The SPC gives age bands rather than a single per-kg rule, so no structured per-kg paediatric dose is recorded here — verify paediatric dosing against a children's formulary.