Pediatric allergic reaction (moderate/severe) includes which epinephrine dose?

• A. 0.001 mg/kg IM
• B. 0.01 mg/kg IM (0.01 ml/kg)
• C. 0.1 mg/kg IM
• D. 0.5 mg IM

Answer: (B)

In pediatric anaphylaxis, the first-line treatment is intramuscular epinephrine at a 1:1000 concentration given as a weight-based dose of 0.01 mg per kilogram per dose, with a maximum of about 0.3 mg per dose and the option to repeat every 5–15 minutes as needed. This 0.01 mg/kg dose corresponds to 0.01 mL per kilogram because the solution is 1 mg/mL. For example, a child weighing 20 kg would receive 0.2 mg (0.2 mL). The other doses are not appropriate for children: 0.001 mg/kg is too small to treat the reaction effectively, 0.1 mg/kg is far too high for a pediatric patient, and 0.5 mg is the adult dose and exceeds safe pediatric limits.