Loading Calculator...
Please wait a moment
Please wait a moment
Emergency epinephrine dosing and treatment protocol
Anaphylaxis is a life-threatening emergency. This calculator is for EDUCATIONAL purposes ONLY. IMMEDIATELY call 911 and administer epinephrine if available. DO NOT delay treatment. Follow your local emergency protocols and medical direction.
| Age Group | Dose | Concentration | Route | Repeat |
|---|---|---|---|---|
| Adult | 0.3-0.5 mg (0.3-0.5 mL) | 1:1000 (1 mg/mL) | IM thigh | Every 5-15 min |
| Pediatric | 0.01 mg/kg (max 0.5 mg) | 1:1000 (1 mg/mL) | IM thigh | Every 5-15 min |
| Infant (<10 kg) | 0.01 mg/kg (0.1-0.15 mg) | 1:1000 (1 mg/mL) | IM thigh | Every 5-15 min |
| IV (refractory) | 0.1-0.5 mg slow push | 1:10,000 (0.1 mg/mL) | IV | Infusion if needed |
IM = Intramuscular; IV = Intravenous. IM is preferred initial route.
Recurrence of symptoms 4-12 hours after initial resolution, occurring in 20% of cases.
All patients should be observed for at least 4-6 hours. Severe cases may require 12-24 hour observation.
Prescribe epinephrine auto-injector (EpiPen), teach proper use, and refer to allergist.
IM injection into the thigh provides rapid, predictable absorption with lower risk of dosing errors. IV epinephrine requires careful dilution and slow administration to avoid cardiovascular complications.
NO. Epinephrine is the ONLY first-line treatment for anaphylaxis. Antihistamines and corticosteroids are adjunct therapy only and should never replace epinephrine.
Beta-blockers may reduce epinephrine effectiveness and cause refractory hypotension/bradycardia. Consider glucagon 1-2 mg IV as it bypasses beta-receptors. Still give epinephrine as first-line.
IV epinephrine is reserved for refractory cases, cardiac arrest, or patients with IV access already in place. Use 1:10,000 concentration (NOT 1:1000) and give slow push or infusion.
Anaphylaxis involves multi-system symptoms (respiratory, cardiovascular, GI) or isolated hypotension after allergen exposure. Isolated hives without other symptoms is not anaphylaxis.
In anaphylaxis, the benefits far outweigh risks. There are NO absolute contraindications. Potential effects include tachycardia, hypertension, anxiety, and in rare cases, arrhythmias (especially with IV dosing).