PALS Drugs – Epinephrine & Amiodarone
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Article at a Glance
- During a pediatric arrest, epinephrine and amiodarone are commonly administered.
- The provider must quickly and accurately calculate dosages.
- The correct concentration of these medications: epinephrine 1mg of 1:10,000 and amiodarone 150 mg/3 mL.
- Epinephrine first dose = 0.1 mL/kg.
- Amiodarone first dose = same amount of fluid as the epinephrine first dose.
Here’s a tip for medication administration during a pediatric arrest. The two drugs we will talk about are epinephrine and amiodarone. There is a ton of tricks and tips out there in Emergency Medical Services (EMS), but when it comes to medication administration, you must make absolutely sure that your concentrations are correct. For this trick, use standard epinephrine 1:10,000 0.1 mg/mL strength (1 mg per 10 mL). For the amiodarone, use a 150 mg/3 mL vial. These strengths are pretty standard, but you absolutely have to double-check to make sure you have the right concentration. Always verify that you are using the correct strength of epinephrine and amiodarone. This is an excellent trick because probably the first two drugs considered in a pediatric arrest are epinephrine, a vasopressor, and then if needed later, an antiarrhythmic such as amiodarone. For the epinephrine, the first dose is 0.01 mg/kg. Now, that’s the same as 0.1 ml/kg. Let’s say your pediatric patient weighs 8 kg. For the 0.1 ml/kg calculation, you’re going to draw up 0.8 mL of 1:10,000 epinephrine. That’s your first dose of epinephrine. Now, the amount that you drew up for epinephrine is the same amount of fluid you would draw up of the amiodarone to administer amiodarone 5 mg/kg initial starting dose. So again, we’re talking about the amount of fluid we’re drawing up for each drug. Read: Reviewing the 421 Formula for IV Rates Using this trick, the mL of epinephrine is the same as the mL of amiodarone. The starting dose for amiodarone is based on 5mg/kg..Understanding the Epinephrine and Amiodarone Trick
Related Video – Point One PALS Drugs
To review, for epinephrine 0.1 mL/kg and an 8 kg kid, that’s 0.8 mL of epinephrine. If it turns out that we’re proceeding with our arrest and we’d have to go to an antiarrhythmic and choose amiodarone, draw up that same amount of fluid out of the 150 mg in 3mL vial to administer 5 mg/kg. These tips help to reduce stress and improve patient care, but they must be used with caution. Make sure you’re using the proper concentrations.Summary
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