Adrenaline IM (Paediatric — Anaphylaxis)

VERBATIM §4.2 (Adults): 'The usual dose is 0.5 mg (0.5ml of adrenaline 1mg/ml (1:1000)).' Route rationale, VERBATIM: 'The intramuscular (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... The subcutaneous route for adrenaline is not recommended for treatment of an anaphylactic reaction as it is less effective.' 'The needle used for injection needs to be sufficiently long to ensure that the adrenaline is injected into muscle.' ROUTE WARNING, VERBATIM: 'Do not give Adrenaline (Epinephrine) 1mg/ml (1:1000) solution for injection intravenously. Intravenous administration of adrenaline for anaphylaxis requires the use of a 1:10,000 adrenaline solution.' maxDose left empty deliberately: the SPC states a usual dose that may be repeated, and gives no dose ceiling with an explicit maximum cue. ELDERLY: 'There are no specific dosage regimes for adrenaline injection in elderly patients. However, Adrenaline should be used with great caution in these patients who may be more susceptible to the cardiovascular side effects of adrenaline.' Administration by a trained healthcare professional.

dosePerKg is null deliberately: the SPC's paediatric anaphylaxis regimen is AGE-BANDED with fixed milligram doses, and the only per-kilogram figure it gives (0.01 mg/kg) applies to infants under 6 months ONLY — it is not valid across the paediatric range, so it must not drive a weight calculator. VERBATIM §4.2 'Paediatric population — The following doses of Adrenaline (Epinephrine) 1 mg/ml (1:1000) Solution for Injection are recommended: Over 12 years 0.5 mg IM (0.5ml 1mg/ml (1:1000) solution) [0.3 mg IM (0.3ml) if the child is small or pre-pubertal]; 6 - 12 years 0.3 mg IM (0.3ml 1mg/ml (1:1000) solution); 6 months - 6 years 0.15 mg IM (0.15ml 1mg/ml (1:1000) solution); Under 6 months 0.01mg/kg IM (0.01ml/kg 1mg/ml (1:1000) solution). If necessary, these doses may be repeated several times at 5 - 15 minutes intervals according to blood pressure, pulse and respiratory function. A small volume syringe should be used.' concentration = 1 because the source product is adrenaline 1 mg/ml (1:1000) — 1 mg per mL. maxDose left empty deliberately: no dose ceiling is stated with an explicit maximum cue; 0.5 mg is the over-12 band dose, not a declared maximum. DO NOT give this 1:1000 strength intravenously. Auto-injector devices are not dosed in this SPC. Verify any under-18 dose against a children's formulary before administration.