A 7-year-old (weight 20 kg) presents in anaphylaxis after a bee sting. Per PALS guidelines, what is the correct dose and route of epinephrine?
- A 0.01 mg/kg (0.2 mg) IM into the anterolateral thigh ✓
- B 0.1 mg/kg IV bolus of 1:10,000 concentration
- C 0.01 mg/kg subcutaneously into the deltoid
- D 0.001 mg/kg IM into the gluteus maximus
Correct answer: A. 0.01 mg/kg (0.2 mg) IM into the anterolateral thigh
Explanation
For anaphylaxis in children, epinephrine 0.01 mg/kg (max 0.5 mg) of 1:1000 concentration is given intramuscularly into the anterolateral thigh, which provides faster and more reliable absorption than subcutaneous or gluteal injection. In this 20 kg child, the dose is 0.2 mg. IV epinephrine is reserved for cardiac arrest. Subcutaneous and gluteal routes give slower, less predictable absorption.
Reference: Ghai Essential Pediatrics, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.