Want to watch this video? Sign up for the course here. Or enter your email below to watch one free video.

Unlock This Video Now for FREE

This video is normally available to paying customers.
You may unlock this video for FREE. Enter your email address for instant access AND to receive ongoing updates and special discounts related to this topic.

Epinephrine is commonly known as adrenaline. It is a chemical that narrows blood vessels and opens airways in the lungs and it can reverse severely low blood pressure. Epinephrine is secreted mainly by the adrenal glands in the medulla and it functions primarily to increase cardiac output and to raise blood glucose levels. Epinephrine is normally released during acute stress. It prepares an individual for the fight or flight, which is why it is a primary medication for nonprofusing cardiac arrests. Epinephrine is a sympathomimetic which is used to stimulate alpha and beta-adrenergic receptors. Once given, the myocardial and cerebral blood flow is enhanced during CPR. And this means that CPR is more effective due to the increased peripheral resistance which will improve the profusion pressures. Other times, adrenaline is used is to reverse the allergic manifestations in acute anaphylaxis. It's also used to relieve bronchospasm in acute and severe asthma despite nebulization therapy.

Epinephrine usually comes in prefilled syringes or ampules containing one milligram of epinephrine in one millilitre, which is a 1:1000 or one milligram of adrenaline in 10 millilitres, which is a 1:10,000 dilution. The main contraindications is not to give a repeated dose of adrenaline in hypothermic patients. Severe hypertension could occur in patients that are on non-cardio selective beta-blockers like Propranolol. In CPR cases, epinephrine is administered with shockable rhythms after the third shock and then after alternative shocks, therefore, after the third, fifth, seventh shock. With non-shockable rhythms, adrenaline is administered immediately after IV access is achieved, followed by alternative cycles. The dose will vary on the age of the patient, which one and the concentration you are administering and it is administered intravenously or intraosseously. With anaphylaxis and life-threatening asthma, epinephrine is administered in the anterior lateral aspect of the thigh.