Push-dose Epi: One out, One in - Makes 10
from Emergency Medicine Mnemonics Hosted by Aaron Tjomsland
How to Mix Push-dose Epi: One out, one in — makes ten Goal concentration: 10 mcg/mL Step-by-Step Mixing: 1. Start with a 10 mL syringe of normal saline (NS) • empty 1 mL to retain 9 mL of NS in the syringe. 2. • This is the standard “cardiac arrest epi” amp (usually 1 mg in 10 mL)…the 1:10,000 prefilled syringe used during ACLS 3. Withdraw 1 mL of the 1:10,000 epi (this gives you 100 mcg) using 3 mL syringe. 4. Inject that 1 mL (100 mcg) into your syringe of 9 mL NS. • Now you have 10 mL of epinephrine at 10 mcg/mL — ready to use. So what we just did is the mnemonic: One out, one in — makes ten ⸻ • What’s the concentration of the code cart epi? • How much do you withdraw? • What do you inject it into? • What’s the final concentration? You should be able to say it out loud, now. If not — just repeat the podcast a couple of times to get it solid. ⸻ How to Administer: • Dose: 1–2 mL IV push every 1–5 minutes PRN hypotension • That’s 5 to 20 micrograms per dose — meaning 0.5 to 2 mL of your push-dose epi, depending on the patient’s response. • Titrate to clinical effect (aim for MAP >65 or ROSC support)
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