Following the nebulized epi thread, I have become less certain of the
"right" nebulized epi dose. The study that got many of us using epi in
patients with bronchiolitis used 3 cc of 1:1000. That is what we use
here at UNC and kids tolerate it well.
However many references site much lower doses for stridor/croup (e.g.,
0.25 cc of 1:1000 epi diluted with 2.5 cc of saline or 0.25 cc r. epi
2.25%). Is there any rationale to this? If you are in the more is
better camp, and the goal is mm's of decrease in airway edema, is there
any reason not to use the 3.0 ml of 1:1000 epi in children with croup?
Our nursing staff gets very confused over our use of epi nebs and I am
at a loss to give them a clear explanation. Any thoughts?
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