Adrenaline

• Adrenaline 1:1000 (1mg/ml):

  • Anaphylaxis or life-threatening asthma
  • Stimulates alpha and beta adrenoreceptors = increased heart rate and contractility, causes vasoconstriction, relieves bronchospasm and suppresses histamine
  • Anaphylaxis - reduces swelling in the airways and raises BP
  • Asthma - bronchodilatory effects
  • Administration - IM
  • Beware of severe hypertension in patients on non-cardio-selective beta-blockers e.g. propranolol
• Adrenaline 1:10,000 (1mg/10ml):

  • In cardiac arrest or for hypotensive patients post ROSC
  • Stimulates alpha and beta adrenoreceptors - vasoconstriction which increases peripheral resistance, enhancing myocardial and cerebral blood flow
  • Administration - IV or intraosseous
  • Non-shockable rhythm - first dose once IV/IO access is achieved
  • Shockable rhythm - first dose after 3 shocks
• Doses:

  • Cardiac arrest (by slow IV injection) = 1mg (1:10,000) (10ml), every 3-5 mins
  • Anaphylaxis = 500 micrograms (1:1000) (0.5ml), repeat dose after 5 minutes if no response