In ACLS, epinephrine is used in cardiac arrest. For pulseless electrical activity (PEA) or asystole, what is the recommended dose and timing?

• A 0.1 mg IV every 5 minutes for 3 doses maximum
• B 0.5 mg IM immediately then 0.5 mg IV at 5 minutes
• C 1 mg IV every 3–5 minutes, without dose limit ✓
• D 5 mg IV as a single loading dose

Explanation

For cardiac arrest (whether PEA, asystole, or shockable rhythms after initial defibrillation attempts), epinephrine 1 mg IV is administered every 3–5 minutes throughout the resuscitation without a defined maximum number of doses. Epinephrine's alpha-1 adrenergic effect increases systemic vascular resistance and improves coronary and cerebral perfusion pressure during CPR. For anaphylaxis (not cardiac arrest), the dose is 0.3–0.5 mg IM into the anterolateral thigh.

Reference: Morgan & Mikhail's Clinical Anesthesiology, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.