Inotropic support: adrenaline

Following beta-blocker poisoning, if hypotension and bradycardia persist after initial resuscitation with intravenous fluids and atropine, give adrenaline. Use:

adrenaline (epinephrine) 10 to 20 micrograms (child: 0.1 micrograms/kg) intravenously, every 2 to 3 minutes aiming for adequate perfusion (guided by heart rate and blood pressure) beta-blocker poisoning adrenaline (epinephrine)

FOLLOWED BY

adrenaline (epinephrine) by intravenous infusion (see Adrenaline (epinephrine) intravenous infusion instructions for advice on preparation and administration).

In cardiogenic shock, if the inotropic response to adrenaline is inadequate, seek advice from a clinical toxicologist on whether to add HIET.

For treatment of refractory hypotension and cardiac arrest, see here.