Adrenaline

Question 1

Adrenaline - Type

Answer 1

Naturally occurring catecholamine

Question 2

Adrenaline - Presentation

Answer 2

1: 10,000 - 1mg in 10 ml
1: 1,000 - 1mg in 1ml

Question 3

Adrenaline - Actions

Answer 3

1. a effect - peripheral vasoconstriction
2. b1 effects - increased rate sinus node
   - increased myocardial contractility
   - increased AV conduction
   - increased myocardial irritability
3. b2 effects - bronchodilation
   - vasodilation of skeletal muscle

Onset IV 30 sec IM 30-90 sec

Max effect IV 3-5 min IM 4-10 min

Question 4

Adrenaline - Uses (7)

Answer 4

1. VF/VT - no output
2. Asystole
3. PEA
4. Anaphylaxis
5. Severe life threatening asthma
6. Bradyarrhythmias resistant to atropine
7. Severe upper airway obstruction due to swelling

Question 5

Adrenaline - Adverse effects (3)

Answer 5

1. Tachycardia
2. Tachyarrhythmias
3. Hypertension

Question 6

Adrenaline - Contraindication

Answer 6

Known hypersensitivity

Question 7

Adrenaline - Precautions (3)

Answer 7

Only apply to pts with cardiac output

1. Care in pts with PHx of HT
2. Care in pts with PHx of IHD
3. Give extremely slowly to pts on MAOI antidepressants, as adrenaline may provoke a greatly exaggerated response. Generally they should receive no more than ¼ of the normal dose of adrenaline, titrated to response.

Question 8

Adrenaline - Doses

Answer 8

Cardiac arrest:

Adult - 1mg IV/IO fast. No max

Paediatric - 0.01mg/kg IV/IO fast. No max

• 0.02mg/kg ETT NEWBORN ONLY

Anaphylaxis/severe life threatening asthma

Adult - 0.5mg IM. Repeat x 1 as req

• infusion 1mg in 500ml NS (2mcg/ml) titrated

Paediatric - 0.01mg/kg IM to max 50kg. Repeat x 1 as req

• infusion 1mg in 500ml NS (2mcg/ml) titrated

Bradyarrhythmias resistant to atropine

Adult & Paediatric - IV adrenaline by infusion titrated

ALWAYS USE BURETTE FOR INFUSIONS

Severe upper airway swelling

Weight >10kg - neb 5ml 1:1000

Weight <10kg - neb 0.5ml/kg 1:1000, dilute to 5ml with NS