Advanced Life Support (ALS) Level 3 (VTQ)

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All About Epinephrine (Adrenaline)

Understanding Epinephrine

A Versatile Chemical for Critical Situations

  • Alias Adrenaline: Epinephrine is commonly known as adrenaline.
  • Physiological Effects: It narrows blood vessels, opens airways in the lungs, and can reverse severely low blood pressure.
  • Source and Function: Mainly secreted by the adrenal glands in the medulla, it primarily increases cardiac output and raises blood glucose levels.
  • Stress Response: Normally released during acute stress, preparing an individual for "fight or flight," making it a primary medication for nonprofusing cardiac arrests.
  • Sympathomimetic Properties: Epinephrine is a sympathomimetic agent that stimulates alpha and beta-adrenergic receptors.

Medical Uses of Epinephrine

When and How Epinephrine Is Administered

  • Enhanced Blood Flow: Improves myocardial and cerebral blood flow during CPR, increasing peripheral resistance and profusion pressures.
  • Allergic Manifestations: Used to reverse acute anaphylaxis's allergic manifestations.
  • Bronchospasm Relief: Administered to relieve acute and severe asthma-related bronchospasms despite nebulization therapy.

Epinephrine Dosage and Administration

Forms, Dosage, and Contraindications

  • Available Forms: Epinephrine is available in prefilled syringes or ampules with various concentrations (1:1000 or 1:10,000).
  • Contraindications: Avoid repeated doses in hypothermic patients; caution in non-cardioselective beta-blocker users like Propranolol.
  • CPR Administration: Given with shockable rhythms after the third shock and alternately (third, fifth, seventh shocks); with non-shockable rhythms, administered after achieving IV access and following alternative cycles.
  • Age and Concentration Variations: Dosage depends on the patient's age and the concentration used; administered intravenously or intraosseously.
  • Anaphylaxis and Asthma: Administered in the anterior lateral aspect of the thigh for anaphylaxis and life-threatening asthma.