In adult allergic reaction (anaphylactic shock), what is the Push-Dose Epinephrine regimen?

• A. Epinephrine 0.5 mg IM
• B. Push-Dose Epinephrine (1:100,000): 1 ml every 30 seconds (IO Preferred)
• C. Albuterol: 2.5 mg Nebulized
• D. Solu-Medrol: 125 mg IV/IO/IM (1 dose)

Answer: (B)

Push-dose epinephrine is used to provide rapid, titratable vasopressor support in adults with anaphylactic shock when IV access is being established or is difficult to obtain. It lets you raise blood pressure and improve perfusion quickly without waiting for a large IV bolus or a full infusion. The regimen given uses a dilute epinephrine solution at 1:100,000 concentration and delivers 1 mL every 30 seconds. That translates to about 10 micrograms per dose, or roughly 20 micrograms per minute, allowing continuous, controlled adjustment based on the patient’s response. The intraosseous route is noted as preferred in this context because it offers fast, reliable access in emergencies, enabling prompt titration of the dose.

The other options reflect different treatments used in anaphylaxis but not the immediate, titratable hemodynamic support described here. A standard IM epinephrine dose is the first-line treatment for anaphylaxis, but it’s not a push-dose IV/IO regimen. Albuterol addresses bronchospasm rather than overall perfusion, and Solu-Medrol is a corticosteroid with a slower onset that doesn’t provide the immediate stabilization needed in shock.