Peter AntevyNationally recognized EMS and pediatric emergency medicine leader, innovator, and educator.

Handtevy Minute - How to dose Epi 1:1,000 IM

Name: Handtevy Minute - How to dose Epi 1:1,000 IM
Uploaded: 2015-09-21T20:23:17+00:00
Duration: 1 min 36 s
Channel: Peter Antevy
Description: Peter Antevy teaches IM epinephrine 1:1,000 dosing for pediatric anaphylaxis. Inject into the lateral thigh for an 8-minute peak instead of 30 minutes…

21 Sept 2015 · 2 min

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1:36

Peter Antevy teaches IM epinephrine 1:1,000 dosing for pediatric anaphylaxis. Inject into the lateral thigh for an 8-minute peak instead of 30 minutes with subcutaneous. Use the age-to-weight rule: a 5-year-old weighs 20 kg, so give 0.2 mL.

Questions this video answers

IM lateral thigh: 8 minutes peak; subcutaneous: 30 minutes peak.

Ages 1, 3, 5, 7, 9 years map to weights 10, 15, 20, 25, 30 kilograms respectively.

Move the decimal point two places to the left in the weight (kg) to get mL (e.g., 10 kg →0.1 mL; 15 kg →0.15 mL).

1 year (10 kg) → 0.1 mL; 3 years (15 kg) → 0.15 mL; 5 years (20 kg) → 0.2 mL; 7 years (25 kg) → 0.25 mL; 9 years (30 kg) → 0.3 mL.

Chapters

Let's talk about one to a thousand epinephrine. Remember that's your very concentrated dose of epinephrine. Now that dose of epinephrine should only be given intramuscularly. Years ago you were taught to give epinephrine subcutaneously. But we know now that epinephrine given in the lateral thigh intramuscularly has an 8 minute peak concentration versus the sub Q which is 30 minute peak. Lets now move into how to dose these medications appropriately. Let's start with the 1 to 1000 epinephrine. Remember that's a concentrated version and that goes IM. You simply use your hand to determine the child's age in years and then the weight in kilograms. 1, 3, 5, 7, 9 as the age in years and 10, 15, 20, 25, 30. That's the weight in kilograms. Once you use the method to determine the patient's weight, you simply move the decimal point over twice and that's how many mls you give the patient. Im for example, a 1 year old child weighs 10 kilos. Decimal point over twice, that's 0.1 ML given im a 3 year old 15 kilo child, decimal point over twice, that's 0.15 ML im a 5 year old 20 kilo child gets 0.2 ML. A 7 year old 25 kilo child gets 0.25 ML and a 9 year old 30 kilo child gets 0.3 ML. Im again, for severe anaphylaxis or severe asthma, those patients are typically still alive.