What is the pediatric epinephrine auto-injector dose commonly used in EMS?

• A. 0.3 mg IM
• B. 0.15 mg IM (1:1000); could be weight-based 0.01 mg/kg up to 0.3 mg
• C. 0.01 mg/kg up to 0.3 mg
• D. 0.5 mg IM

Answer: (B)

In pediatric anaphylaxis, epinephrine is given intramuscularly at a 1:1000 concentration. The most common EMS pediatric auto-injector dose is 0.15 mg per dose, delivered IM. This fixed pediatric dose fits the majority of children and aligns with widely used autoinjector devices, making rapid, safe administration in the field straightforward.

If a clinician uses weight-based dosing instead of an auto-injector, the guideline is 0.01 mg/kg per dose, up to a maximum of 0.3 mg. This means smaller children get a smaller dose according to weight, while larger children approach the 0.3 mg ceiling.

The other options aren’t the standard pediatric auto-injector dose: 0.3 mg is typically used for larger children or adults, and 0.5 mg is not a typical pediatric dose.