Adrenaline Flashcards
(21 cards)
What are the 4 indications for adrenaline (epinephrine) use?
Cardiac arrest
Anaphylaxis
Severe life-threatening bronchospasm OR silent chest
Croup
True or False: Adrenaline is a natural hormone produced by the adrenal glands.
True - which sit on top of your kidneys
What are the precautions of administration for adrenaline?
Hypertension
Hypovolaemic shock
Concurrent MAOI therapy (Monoamine oxidase inhibitors)
Quetiapine toxicity (Seroquel)
What are the common routes of administration for adrenaline?
Intramuscular (IM)
Intravenous (IV)
Nebuliser (NEB)
What is the recommended IM dose of adrenaline for an adult experiencing anaphylaxis?
0.5 mg IM (500mcg)
Repeated at 5min intervals
No max
What are the 5 actions of the adrenergic receptors - alpha and beta?
Increased heart rate (B1)
Increased force of myocardial contraction (B1)
Increased irritability of the ventricles (B1)
Bronchodilation (B2), and
Peripheral vasoconstriction (A1)
What is the recommended NEB dose of adrenaline for an adult experiencing anaphylaxis?
5mg NEB (sinlge dose only)
*Upper airway obstruction refractory to 3 x IM adrenaline injections
What is the presentation of adrenaline?
1mg/1mL (1:1,000)
1mg/10mL (1:10,000) - paediatric
What are some side effects of administering adrenaline?
Anxiety
Hypertension (vasoconstriction)
Palpitations / tachyarrhythmias
Pupil dilation
Tremor
What drug class is adrenaline?
Sympathomimetic - mimics the “fight or flight” response (acts like adrenaline and stimulates the sympathetic nervous system)
What is the onset and duration of adrenaline?
Onset: 30sec IV, 60sec IM
Duration: 5 - 10mins
What is the recommended IV dose of adrenaline for an adult experiencing cardiac arrest?
1mg
Repeated every 3-5mins
No max
What is the recommended dose/route of adrenaline for an adult experiencing bronchospasm OR slient chest?
0.5 mg IM (500mcg)
Repeated at 5min intervals
No max
Same as anaphylaxis
What is the recommended dose/route of adrenaline for a paediatric experiencing croup?
5mg NEB (single dose only)
What is the recommended dose/route of adrenaline for a paediatric experiencing bronchospasm OR slient chest?
> 6yo
300mcg
1 - 6yo
150mcg
6mth - 1yo
100mcg
<6mth
50mcg
All IM
Repeat at 5min intervals
No max
What must severe life-threatening bronchospasm OR silent chest have?
Speak in single words, AND/OR
Haemodynamic compromise, AND/OR
ALOC
Is the recommended IM dose of adrenaline for a paediatric experiencing anaphylaxis the same as bronchospasm OR silent chest?
Yes
What is the recommended NEB dose of adrenaline for a paediatric experiencing anaphylaxis?
5mg NEB (sinlge dose only)
*Upper airway obstruction refractory to 3 x IM adrenaline injections
What is the recommended dose/route of adrenaline for a paediatric experiencing cardiac arrest?
> 1yo (>10kg) = 10mcg/kg
6mth - 12mth = 100mcg
3mth - 5mth = 70mcg
38wks - 2mth = 50mcg
27wks - 37wks = 25mcg
<27wks = 10mcg
What presentation should be used for NEB adrenaline administeration?
1:1,000 (1mg/mL)
What presentation should be used for low dose IM/IV adrenaline administeration?
1:10,000 (1mg/10mL)
