Method of Intravenous Epinephrine Bolus Injection

Epinephrine intravenous (IV) injection is primarily used for the emergency treatment of anaphylactic shock and cardiac arrest (i.e., cessation of heartbeat and respiration). When used to treat cardiac arrest, epinephrine is administered IV at a dose of 1 mg per injection, repeated every 3–5 minutes.

To ensure epinephrine reaches the heart effectively, a 20-mL bolus of normal saline should be administered immediately after peripheral IV injection. For anaphylactic shock, epinephrine is administered as an immediate intramuscular (IM) injection; if ineffective, a repeat IM injection may be given no sooner than 5 minutes later.

If repeated IM injections are required, IV administration should be considered instead. When administering epinephrine IV, it must first be diluted: one ampoule of epinephrine hydrochloride injection (1 mL: 1 mg, 1:1000) is mixed with 9 mL of normal saline to yield a 1:10,000 dilution. The recommended IV dose is 0.5–1 mg (i.e., 5–10 mL of the diluted solution), administered slowly over ≥5 minutes.

Epinephrine is a hormone secreted by the human body. It is released in response to certain stimuli—such as excitement, fear, or stress—and acts to accelerate respiration (thereby increasing oxygen supply), increase heart rate and blood flow, dilate the pupils, and mobilize energy for physical activity, thereby enhancing reaction speed. Epinephrine functions both as a hormone and a neurotransmitter, secreted primarily by the adrenal medulla. It increases myocardial contractility and induces vasodilation in the coronary arteries, hepatic vessels, and skeletal muscle vasculature, while simultaneously causing vasoconstriction in cutaneous and mucosal vessels. It is an essential life-saving agent for critically ill or near-fatal patients and animals.