What is the recommended epinephrine dose for pediatric anaphylaxis?

• A. 0.1 mg/kg IM
• B. 0.01 mg/kg of 1:1000 IM epinephrine, maximum single dose of 0.3 mg, repeat as needed per protocol.
• C. 0.001 mg/kg IV
• D. 0.2 mg/kg IM

Answer: (B)

In pediatric anaphylaxis, use a weight-based intramuscular dose of epinephrine at 1:1000 concentration. The amount is 0.01 mg per kilogram of body weight, with a maximum single dose of 0.3 mg. This dosing delivers rapid reversal of airway swelling and bronchospasm while keeping the risk of adverse effects in check. The injection is given into the mid-outer thigh and can be repeated every 5–15 minutes as needed per protocol.

For example, a 20 kg child would receive 0.2 mg per dose; a 40 kg child would hit the 0.3 mg maximum. IV epinephrine is not the standard initial route for pediatric anaphylaxis in most prehospital settings, and a dose like 0.001 mg/kg IV is not appropriate for routine management.