Midstate Regional Emergency Medical Advisory Committee
2521 Sunset Ave.
Utica NY 13512<\/p>\n
TO: Midstate EMS ALS Agencies August 1, 2012
From: John DeTraglia MD, REMAC Chair
RE: Epinephrine Shortage<\/p>\n
***EPINIEPHRINE 1:10,000 1 mg\/ 10ml prefilled syringe:<\/p>\n
Due to current and possible future shortages of Epinephrine 1:10,000 1mg\/10ml prefilled syringes reported by the Food and Drug Administration (FDA), the following plan should be followed if your agency stock becomes low or exhausted.<\/p>\n
Option 1: Utilizing Epinephrine 1:1,000 1mg\/ml 30 ml vial
Make Epinephrine 1:10,000 1 mg\/10 ml using
Epinephrine 1:1,000 1mg\/ml 30 ml vial
\u00ef\u201a\u00b7 Step 1 Add 5 mg (5ml) Epinephrine 1:1,000 into a 50 ml bag of NS
\u00ef\u201a\u00b7 Step 2 Draw up 10 ml from the NS bag (that has been mixed with the 5 mg of Epinephrine 1:1,000) into a 10 cc syringe.
\u00ef\u201a\u00b7 Administer to patient
\u00ef\u0192\u02dc After the 50 ml NS bag is mixed with the Epinephrine 1:1,000, you will have 5 doses of Epinephrine 1:10,000 available
\u00ef\u0192\u02dc The actual concentration will be approximately 0.9 mg. The negligible difference is felt to be acceptable in this setting.
\u00ef\u0192\u02dc Should personnel and resources be available, then certainly 5 mL of normal saline can be withdrawn from the 50 ml bag prior to instilling 5 mg (5mL) of Epinephrine 1:1000. This will result in a concentration of 1 mg. <\/p>\n
Option 2: Utilizing Epinephrine 1:1,000 1 mg\/ml ampule
Make Epinephrine 1:10,000 1mg\/10ml using Epinephrine 1:1,000 1mg\/ml ampule
\u00ef\u201a\u00b7 Step 1 Expel 1 ml of normal saline from a pre-filled syringe and instill 1 mg (1mL) of Epinephrine 1:1,000
EITHER OF THESE TWO ADDITIONAL OPTIONS IS ACCEPTABLE. REMEMBER TO DISCARD ANY UNUSED DOSES OF EPINEHRINE AFTER EACH PATIENT. THESE EXTRA STEPS AND ADDITOINAL AVENUES INCREASE THE POTENTIAL FOR ERRORS, ADDITONAL VIGILANCE WILL BE NECESSARY. <\/p>\n
***Ondansetron (Zofran) 4mg\/2ml vials:
Shortages have been reported and the Midstate REMAC approved the use of Ondansetron 4 mg Orally Disintegrating Tablets (ODT) if necessary.<\/p>\n","protected":false},"excerpt":{"rendered":"
Midstate Regional Emergency Medical Advisory Committee 2521 Sunset Ave. Utica NY 13512 TO: Midstate EMS ALS Agencies August 1, 2012 From: John DeTraglia MD, REMAC Chair RE: Epinephrine Shortage ***EPINIEPHRINE 1:10,000 1 mg\/ 10ml prefilled syringe: Due to current and possible future shortages of Epinephrine 1:10,000 1mg\/10ml prefilled syringes reported by the Food and Drug […]<\/p>\n","protected":false},"author":13,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-1424","post","type-post","status-publish","format-standard","hentry","category-announcement"],"_links":{"self":[{"href":"https:\/\/midstateems.dreamhosters.com\/blog\/wp-json\/wp\/v2\/posts\/1424","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/midstateems.dreamhosters.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/midstateems.dreamhosters.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/midstateems.dreamhosters.com\/blog\/wp-json\/wp\/v2\/users\/13"}],"replies":[{"embeddable":true,"href":"https:\/\/midstateems.dreamhosters.com\/blog\/wp-json\/wp\/v2\/comments?post=1424"}],"version-history":[{"count":1,"href":"https:\/\/midstateems.dreamhosters.com\/blog\/wp-json\/wp\/v2\/posts\/1424\/revisions"}],"predecessor-version":[{"id":1425,"href":"https:\/\/midstateems.dreamhosters.com\/blog\/wp-json\/wp\/v2\/posts\/1424\/revisions\/1425"}],"wp:attachment":[{"href":"https:\/\/midstateems.dreamhosters.com\/blog\/wp-json\/wp\/v2\/media?parent=1424"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/midstateems.dreamhosters.com\/blog\/wp-json\/wp\/v2\/categories?post=1424"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/midstateems.dreamhosters.com\/blog\/wp-json\/wp\/v2\/tags?post=1424"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}