Pediatric Sepsis: Push-Dose Epinephrine preparation (1:10,000) and administration?

Pediatric Sepsis: Push-Dose Epinephrine preparation (1:10,000) and administration?

• A. 1 mL of 1:10,000 Epi/9 mL Normal Saline (1 mL every 30 seconds)
• B. 1 mL of 1:100,000 Epi/9 mL Normal Saline
• C. 2 mL of 1:10,000 Epi/9 mL Normal Saline
• D. 0.5 mL of 1:10,000 Epi/9 mL Normal Saline

Answer: (A)

Push-dose epinephrine provides rapid, titratable support for blood pressure in children with septic shock when full vasopressor infusions aren’t immediately available. The standard preparation uses a ready-to-dose dilution that can be given in small boluses and titrated to effect. To make the correct solution, mix 1 mL of epinephrine 1:10,000 (0.1 mg) with 9 mL normal saline. This yields 10 mL of solution at 0.01 mg/mL (10 µg/mL). Administer 1 mL of this prepared solution (10 µg) every 30 seconds, adjusting based on the patient’s response and perfusion, while monitoring closely. Using a different dilution or dose would either deliver far less epinephrine or a much larger, less controllable bolus, making this preparation and dosing the appropriate choice for rapid, titratable effect.

Push-dose epinephrine provides rapid, titratable support for blood pressure in children with septic shock when full vasopressor infusions aren’t immediately available. The standard preparation uses a ready-to-dose dilution that can be given in small boluses and titrated to effect.

To make the correct solution, mix 1 mL of epinephrine 1:10,000 (0.1 mg) with 9 mL normal saline. This yields 10 mL of solution at 0.01 mg/mL (10 µg/mL). Administer 1 mL of this prepared solution (10 µg) every 30 seconds, adjusting based on the patient’s response and perfusion, while monitoring closely.

Using a different dilution or dose would either deliver far less epinephrine or a much larger, less controllable bolus, making this preparation and dosing the appropriate choice for rapid, titratable effect.