What is the dose and route of Epinephrine for a 4 year-old (20 kg) patient with anaphylaxis?

What is the dose and route of Epinephrine for a 4 year-old (20 kg) patient with anaphylaxis?

• A. 0.2 mg IM (1:1000)
• B. 0.02 mg IM (1:1000)
• C. 0.4 mg IM (1:1000)
• D. 2.0 mg IM (1:1000)

Answer: (A)

In pediatric anaphylaxis, epinephrine is given intramuscularly at 0.01 mg per kilogram of body weight using a 1:1000 solution, with a maximum single dose of 0.3 mg. For a 20 kg child, that dose is 0.2 mg. Since the 1:1000 concentration equals 1 mg per mL, the volume needed is 0.2 mL. This IM route is chosen because it provides rapid and reliable absorption to counteract airway edema, hypotension, and bronchospasm. The other options don’t fit the recommended plan: 0.02 mg is too small for a 20 kg child; 0.4 mg exceeds the recommended maximum single dose; 2.0 mg is far beyond safe pediatric dosing and could cause severe adverse effects.

In pediatric anaphylaxis, epinephrine is given intramuscularly at 0.01 mg per kilogram of body weight using a 1:1000 solution, with a maximum single dose of 0.3 mg. For a 20 kg child, that dose is 0.2 mg. Since the 1:1000 concentration equals 1 mg per mL, the volume needed is 0.2 mL. This IM route is chosen because it provides rapid and reliable absorption to counteract airway edema, hypotension, and bronchospasm.

The other options don’t fit the recommended plan: 0.02 mg is too small for a 20 kg child; 0.4 mg exceeds the recommended maximum single dose; 2.0 mg is far beyond safe pediatric dosing and could cause severe adverse effects.