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administering epi in infant/neonate arrests

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What does your service use to administer 1:10,000 epi in young pediatric arrests? Can you accurately administer less than 1 ml/.01mg of epi to someone under 10kg using a prefilled 10cc syringe? Do you mix 1:1000 with saline to make 1:10,000 in a 100 units (1ml) syringe?

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Three way stopcock and a 1ml syringe works well for drawing up accurate doses out of a premix.

Take care,

chbare.

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Three way stopcock and a 1ml syringe works well for drawing up accurate doses out of a premix.

Take care,

chbare.

That is such a good idea! I did my PALS course last week and they didn’t mention this, the tricks of the trade hey!

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1 cc syringes are great, and I would advise to think about "super concentrating" some drugs so that can push less fluid on live patients. When I worked at a pediatric hospital, they would put the usual dose of a drug in a 50 or 100cc IV bag, or put 3-5 times the normal dose of a drug in a 250cc bag, so that they could deliver less fluid. The downside of that is you really need to have drugs like that on a pump, but we in EMS are too cheap or are too indifferent to be concerned enough to invest in pumps.

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In NYC, they're proposing big changes in our Pediatric Protocols. As for difficulties in drawing the right amount for pediatrics and neonates, it can be difficult unless you round it up to the nearest whole number and/or to the nearest 5 or 0. If you want to accurately dose the patient; you need to use a IV Pump.

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Don't make this more difficult than it needs to be everybody. I still highly suggest you use a three way stopcock and a one ml syringe. The setup will look like this:

b102577c.jpg

Take care,

chbare.

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Don't make this more difficult than it needs to be everybody. I still highly suggest you use a three way stopcock and a one ml syringe. The setup will look like this:

b102577c.jpg

Take care,

chbare.

This is how I was taught how to do it during my PALS course. Also how I bolus infants.

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Three way stopcock and a 1ml syringe works well for drawing up accurate doses out of a premix.

Take care,

chbare.

Exactly how I was tought, and this is also taught/reinforced in most PALS courses.

Edited by croaker260

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Thanks for that, Chbare! I'll definitely be trying that the next time I have to.

On another note, I did get to use a fourway stopcock the otherday on a patient with SVT. Gave 6mg, 12mg, and then another 12mg of adenosine after trying vagal maneuvers to no success. Eventually they managed to get his rate down in the ER after two boluses of NS.

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