Adrenaline intravenous infusion calculations

Use adrenaline 0.1% or 1:1000 solution which is 1mg/mL [NB1] [NB2] [NB3]. Adults: The standard infusion rate for adults ranges from 1 to 20micrograms/minute (60 to 1200micrograms/hour). For more detail on requirements in anaphylaxis, see Table 14.15. Infusion rates should be initiated at the lower end of the above ranges but can be titrated up approximately every 3 minutes to achieve the desired effects on blood pressure and heart rate. For 50mL bag or syringe driver, use: 3mg/50mL, which gives an infusion concentration of 60micrograms/mL. Therefore run infusion at 1 to 20mL/hour to deliver 1 to 20 micrograms/minute. For 100mL bag, use: 6mg/100mL, which gives an infusion concentration of 60micrograms/mL. Therefore run infusion at 1 to 20mL/hour to deliver 1 to 20 micrograms/minute. For 1000mL bag, use: 6mg/1000mL, which gives an infusion concentration of 6micrograms/mL. Therefore run infusion at 10 to 200mL per hour to deliver 1 to 20 micrograms/minute. Children: For child 30 kg or less, use: 0.3mg/kg in 50mL so that 1mL/hour gives 0.1micrograms/kg/minute. For child more than 30 kg, use: 0.15mg/kg in 50mL so that 1mL/hour gives 0.05micrograms/kg/minute. NB1: A  drenaline is compatible with most standard infusion solutions. In most hospital emergency departments, glucose 5% is used to maintain consistency with use in the intensive care setting, but sodium chloride 0.9% is preferred in management of anaphylaxis. NB2: Adrenaline dose terminology Percent 0.01% 0.1% 1% Ratio 1 in 10 000 1 in 1000 1 in 100 Concentration 1 mg in 10 mL 1 mg/mL (most commonly available) 10 mg/mL

NB3: Noradrenaline is available as a 1:1000 solution, and the same calculations apply to its preparation and use.

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Published in eTG complete, March 2008. Therapeutic Guidelines Ltd. www.tg.org.au