129
EMR
EMT
AEMT
Paramedic
Extended
Epi Push-Dose Pressor
Steps
Performed?
Yes No
1.
Use body substance precautions.
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2.
Unpack a 10mL Normal Saline flush and waste 1mL, leaving 9mL in the syringe.
Attach an 18ga 1.5” intramuscular needle to the saline syringe.
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3.
Unpack a 1:10,000 epinephrine prefilled syringe and draw 1mL of the epinephrine into
the saline flush syringe via the rubber plunger.
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4.
Shake the new diluted saline/epinephrine syringe briefly to mix.
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5.
Place an orange sticker on the syringe and label “Epinephrine 10mcg/mL”
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6.
To administer, start an IV/IO line of normal saline and connect the syringe to the
appropriate IV tubing connector using aseptic technique.
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7.
Administer 0.5-2mL every 2-5 minutes. This equates to an infusion of 2-10mcg/min.
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8.
Monitor the heart rate and blood pressure closely.
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9.
Document the procedure, times, dosages, and any patient response in the Patient Care
Report (PCR).
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Consider the following conversions, once the dilution of 10mcg/mL is achieved:
Every 2 Minutes
0.5mL q 2 min = 2.5 mcg/min
1mL q 2 min = 5 mcg/min
1.5mL q 2 min = 7.5 mcg/min
2mL q 2 min = 10 mcg/min
Every 3 Minutes
0.5mL q 3 min = 1.7 mcg/min
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1mL q 3 min = 3.3 mcg/min
1.5mL q 3 min = 5 mcg/min
2mL q 3 min = 6.7 mcg/min
Every 4 Minutes
0.5mL q 4 min = 1.3 mcg/min
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1mL q 4 min = 2.5 mcg/min
1.5mL q 4 min = 3.8 mcg/min
2mL q 4 min = 5 mcg/min
Every 5 Minutes
0.5mL q 5 min = 1 mcg/min
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1mL q 5 min = 2 mcg/min
1.5mL q 5 min = 3 mcg/min
2mL q 5 min = 4 mcg/min
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Subtherapeutic dosages, not recommended.
Epi Push-Dose Pressor