The Internet Book of Critical Care Podcast

IBCC Episode 77 - Anaphylaxis

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Feb 17, 2020
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ADVICE

Epinephrine's Importance

  • Administer epinephrine immediately if you suspect anaphylaxis, regardless of blood pressure.
  • It's better to manage slightly elevated blood pressure than to have none at all.
INSIGHT

IV Epinephrine Advantages

  • While intramuscular epinephrine is appropriate, intravenous epinephrine offers advantages in the ICU.
  • IV epinephrine allows for faster onset, easier titration, and quicker reversal if needed.
ADVICE

Dirty Epi Drip

  • Create a "dirty epi drip" by adding 1mg of epinephrine (from a cardiac or IM dose) to 1L of saline.
  • This creates a 1 mcg/mL solution, minimizing overdose risk and simplifying titration.
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