What is the maximum single dose of epinephrine for pediatric anaphylaxis?

What is the maximum single dose of epinephrine for pediatric anaphylaxis?

• A. 0.01 mg
• B. 0.3 mg
• C. 1.0 mg
• D. 0.5 mg

Answer: (D)

The key point is dosing for pediatric anaphylaxis: give epinephrine IM at 0.01 mg/kg per dose, but never exceed a single dose of 0.5 mg. Since epinephrine prepared for IM use is commonly 1:1000 (1 mg/mL), a 0.01 mg/kg dose translates to 0.01 mL per kg. That dose is capped at 0.5 mg, so the maximum you administer at one time is 0.5 mg (which is 0.5 mL of 1:1000 solution). For example, a 10 kg child would receive 0.1 mg (0.1 mL), a 40 kg child would receive 0.4 mg (0.4 mL), and a 60 kg child would still receive only 0.5 mg per dose due to the cap. If symptoms persist, a repeat dose can be given after several minutes per protocol, but each dose should not exceed 0.5 mg.

The key point is dosing for pediatric anaphylaxis: give epinephrine IM at 0.01 mg/kg per dose, but never exceed a single dose of 0.5 mg. Since epinephrine prepared for IM use is commonly 1:1000 (1 mg/mL), a 0.01 mg/kg dose translates to 0.01 mL per kg. That dose is capped at 0.5 mg, so the maximum you administer at one time is 0.5 mg (which is 0.5 mL of 1:1000 solution).

For example, a 10 kg child would receive 0.1 mg (0.1 mL), a 40 kg child would receive 0.4 mg (0.4 mL), and a 60 kg child would still receive only 0.5 mg per dose due to the cap. If symptoms persist, a repeat dose can be given after several minutes per protocol, but each dose should not exceed 0.5 mg.