ADRENALINE HYDROCHLORIDE

Adrenaline

Reviewed by NICU and Pharmacy
November 2011
Dose and Pharmacology Newborn Drug Protocol Index Newborn Services Home Page

 

Management of  Adrenaline Administration

Prescription

Continuous Infusions:

Charted on fluid chart giving:

Also charted on drug chart under continuous infusions giving:

Administration

Administration of Intratracheal Adrenaline for Resuscitation

  1. Administered by doctor / NS-ANP or a nurse with neonatal IV Drug Certification.
  2. Dilute in 1-2ml of NS.
  3. Instil into endotracheal tube. May be repeated as necessary.

Continuous Infusion (Use 1:10,000 strength Adrenaline)

  1. Administered by a nurse with Neonatal IV Drug Certification.
  2. Dilute prior to administration.
  3. Do NOT use discoloured solutions.
  4. Filter prior to administration through a Pall 0.2 micron filter.
  5. Compatible with D5W, D10W and NS. Incompatible with alkaline solutions/drugs.
  6. Do NOT mix with other drugs, blood or blood products.
  7. Protect from light during administration. Wrap tubing in tinfoil and cover syringe.
  8. Administer via a syringe pump.
  9. Give through a central venous line (UVC, Longline, or Surgical CVL).

Slow Intravenous Push

  1. Is administered by the doctor / NS-ANP. In an emergency situation the nurse may administer under the direct supervision of the doctor / NS-ANP present.
  2. Further dilution is not necessary. Do not use discoloured solutions.
  3. Administer IV by slow push over 5 minutes.
  4. Filter prior to administration through a Pall 0.2 micron filter.
  5. Compatible with NS, D5W and D10W. Incompatible with alkaline solutions/drugs.
  6. Do NOT mix with other drugs, IV solutions, blood or blood products.
  7. Flush with NS before and after administration of adrenaline.

Administration of Intracardiac Adrenaline

  1. This is a medical staff only procedure.
  2. To be administered with a 22 gauge needle.

Nursing Considerations

  1. Observe IV site for signs of infiltration.
  2. Continuous blood pressure monitoring or 5 minute BP recordings.
  3. Continuous cardiorespiratory monitoring.
  4. Document vital signs hourly and PRN.
  5. Assess need for endotracheal suctioning. Mucous plugs may become more difficult to dislodge.

Storage

References

1 Guys, Lewisham and St Thomas Hospitals, Paediatric Formulary, 3rd Edition 1993, p11.
2 Royal Children's Hospital, Melbourne. Paediatric Pharmacopaeia 11th Edition 1994, p5.