What is the dose and concentration of epinephrine used in cardiac arrest?

• A. Epinephrine 1:1000 1 mg IV
• B. Epinephrine 1:10,000 0.1 mg IV
• C. Epinephrine 1:10,000 1 mg IV/IO q3-5 min; ETT 2-2.5x
• D. Epinephrine 1:1000 0.5 mg IV

Answer: (C)

In cardiac arrest, epinephrine is given to boost blood flow to the heart and brain during CPR by causing peripheral vasoconstriction and supporting perfusion pressures. The standard IV/IO dose is 1 mg of epinephrine in a 1:10,000 solution, repeated every 3-5 minutes. If you’re delivering epinephrine via the endotracheal tube, the dose is increased to about two to two-and-a-half times the IV dose to compensate for poor absorption through the airway. That means about 2-2.5 mg of 1:10,000 epinephrine via ETT, usually diluted appropriately.

The other options use incorrect concentrations or doses for cardiac arrest: a 1:1000 concentration isn’t used IV in this setting, and 0.1 mg or 0.5 mg are not the standard IV/IO dose.