Vasopressors¶: Patients may require large amounts of IV crystalloid to maintain blood pressure. Some patients may require a second vasopressor (in addition to epinephrine). All vasopressors should be given by infusion pump, with the doses titrated continuously according to blood pressure and cardiac rate/function monitored continuously and oxygenation monitored by pulse oximetry.
IM: intramuscular; IV: intravenous.
* A child is defined as a prepubertal patient weighing less than 40 kg.
¶ All patients receiving an infusion of epinephrine and/or another vasopressor require continuous noninvasive monitoring of blood pressure, heart rate and function, and oxygen saturation. We suggest that pediatric centers provide instructions for preparation of standard concentrations and also provide charts for established infusion rate for epinephrine and other vasopressors in infants and children.
In patients with severe symptoms or who are rapidly deteriorating, use an autoinjector if drawing up the dose will cause a significant delay. There are three available autoinjector strengths: 0.1 mg (Auvi-q), 0.15 mg (EpiPen Jr, others), 0.3 mg (EpiPen, others)
