NORCET 2 -2021 (Shift…: Recommended dose of adrenaline (epinephrine) used in pediatrics?

NORCET 2 -2021 (Shift-2)

Pharmacology

Easy

Appeared in: NORCET 2 -2021 (Shift-2)

Explanation

The correct dose for epinephrine in pediatric cardiac arrest is 0.01 mg/kg.
This dose must be administered using the 1:10,000 concentration for IV or IO routes.
A 1:10,000 solution contains 0.1 mg of epinephrine per mL.
Therefore, a dose of 0.01 mg/kg is correctly calculated as a volume of 0.1 mL/kg.
This is the standard guideline from Pediatric Advanced Life Support (PALS).

Option A: This option suggests a dose of 1 mg/kg, which is a 100-fold overdose and would be fatal. It also incorrectly pairs this dose with the 1:1000 concentration for a resuscitation scenario.
Option B: This option suggests a dose of 0.1 mg/kg, which is a 10-fold overdose compared to the recommended 0.01 mg/kg. This is a dangerous and incorrect dose.
Option D: This option suggests a dose of 0.5 mg/kg, which is a 50-fold overdose and would be fatal. It also incorrectly uses the 1:1000 concentration.

Clinical Relevance

Nursing practice connection: Knowing Pediatric dosage calculation for epinephrine (adrenaline) in resuscitation helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Epinephrine is a high-alert medication. Errors in concentration (1:1000 vs 1:10,000) are a common and potentially fatal medication error. Nurses must always confirm the concentration before administration.
In a code situation, closed-loop communication is vital. When drawing up epinephrine, the nurse should state the dose, volume, and concentration out loud for verification by the team leader (e.g., "Drawing up 0.1 mL per kilo of 1-to-10,000 epinephrine").
What if? If IV/IO access is not available during pediatric resuscitation, the endotracheal (ET) route can be used as a last resort. The dose is higher (0.1 mg/kg), and the more concentrated 1:1000 solution is used, diluted with normal saline.

How to Approach the Question

First, identify the key components of the question: the drug (epinephrine/adrenaline), the patient population (pediatrics), and the clinical context (implied resuscitation).
Recall the standard pediatric resuscitation guidelines (PALS) for epinephrine.
Pay extremely close attention to the units: mg/kg (the dose), mL/kg (the volume), and the concentration (1:1000 vs 1:10,000).
Recognize that 1:10,000 is the standard IV/IO concentration for resuscitation.
Mentally calculate or verify the volume. The correct dose is 0.01 mg/kg. The correct concentration is 1:10,000 (which is 0.1 mg/mL). Therefore, the volume is 0.01 mg/kg ÷ 0.1 mg/mL = 0.1 mL/kg.
Evaluate each option against this correct calculation. Option C is the only one that correctly aligns the dose (0.01 mg/kg), volume (0.1 mL/kg), and concentration (1:10,000).

Concept Tested & Keywords

Concept Tested: Pediatric dosage calculation for epinephrine (adrenaline) in resuscitation.
Stem keywords: dose, adrenaline, epinephrine, pediatrics
Lead-in keywords: Recommended dose

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