What is a typical dose of epinephrine for anaphylaxis in EMS?

• A. 0.15 mg IM into the thigh
• B. 0.3 mg IM into mid-thigh
• C. 0.3 mg IV bolus
• D. 0.5 mg IM into the thigh

Answer: (B)

The essential idea is that the typical EMS dose for an adult experiencing anaphylaxis is 0.3 mg given by intramuscular injection into the mid-thigh. This 0.3 mg dose is delivered using a 1:1000 concentration epinephrine and is chosen because IM administration into the thigh provides rapid, reliable absorption to counter airway edema, bronchospasm, and hypotension. For children, a smaller dose of 0.15 mg is used, reflecting weight-based needs. Intravenous epinephrine is not the first choice in the field due to greater risk of serious cardiovascular effects, and a 0.5 mg dose exceeds the standard adult EMS dosing. If symptoms recur, a second dose may be given per local protocol after several minutes.