2005 ACLS 建議. 肌肉注射epinephrine 5-15 分鐘給一次.
Epinephrine
–Absorption and subsequent achievement of maximum plasma concentration after subcutaneous administration is slower and may be significantly delayed with shock.10,11 Thus, intramuscular (IM) administration is favored.
Administer epinephrine by IM injection early to all patients with signs of a systemic reaction, especially hypotension, airway swelling, or definite difficulty breathing.
Use an IM dose of 0.3 to 0.5 mg (1:1000) repeated every 15 to 20 minutes if there is no clinical improvement.
–Administer IV epinephrine if anaphylaxis appears to be severe with immediate life-threatening manifestations.
Use epinephrine (1:10 000) 0.1 mg IV slowly over 5 minutes. Epinephrine may be diluted to a 1:10 000 solution before infusion.
An IV infusion at rates of 1 to 4 μg/min may prevent the need to repeat epinephrine injections frequently.
–Close monitoring is critical because fatal overdose of epinephrine has been reported.3,14
–Patients who are taking β-blockers have increased incidence and severity of anaphylaxis and can develop a paradoxical response to epinephrine.15 Consider glucagon as well as ipratropium for these patients (see below).
https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.105.166568
2015指引. 使用 2010 ACLS建議, 沒有新的變動
The recommended dose is 0.2 to 0.5 mg (1:1000) IM to be repeated every 5 to 15 minutes in the absence of clinical improvement (Class I, LOE C).
https://eccguidelines.heart.org/tables/2015-guidelines-update-part-10-recommendations/
