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Adrenaline concentration and route — DIPIMC MCQ

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HardPharmacology (Pre-Hospital)Adrenaline concentration and routeDIPIMCDipIMC

A patient in anaphylaxis requires intramuscular adrenaline, and a colleague asks about the difference between the 1:1000 and 1:10,000 preparations. Which statement is most accurate?

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Correct answer: E — 1:1000 (1 mg/mL) is intramuscular; 1:10,000 (0.1 mg/mL) is intravenous

Adrenaline 1:1000 contains 1 mg in 1 mL (1 mg/mL) and is the intramuscular preparation for anaphylaxis, whereas 1:10,000 contains 1 mg in 10 mL (0.1 mg/mL) and is the intravenous preparation used in cardiac arrest. The two are not interchangeable, and giving the concentrated 1:1000 solution as an intravenous push risks dangerous hypertension, arrhythmia and myocardial ischaemia. Intramuscular 1:1000 into the anterolateral thigh is the correct route in anaphylaxis. Pearl: intravenous adrenaline in anaphylaxis is reserved for refractory cases as a dilute, titrated infusion given by experienced clinicians with monitoring.

Reference: Resuscitation Council UK (Emergency Treatment of Anaphylaxis)