Epinephrine in US EMS protocols
Includes 4 agencies outside the US.
| Indication | Spread: box is the middle half, dot means most agree | Range |
|---|---|---|
| Allergic reaction Adult | Most use 0.3 mg range 0.25 to 0.5 mg, n=26 | |
| Pediatric | All use 0.15 mg n=9 | |
| Pediatric, weight-based | All use 0.01 mg/kg n=17 | |
| Anaphylaxis Adult | Most use 0.3 mg matches NASEMSO range 0.1 to 0.5 mg, n=199 | |
| Adult | 0.3 to 1 mL median 0.5, n=7 | |
| Adult, weight-based | All use 0.01 mg/kg matches WAO n=5 | |
| Pediatric | Most use 0.15 mg range 0.15 to 0.3 mg, n=69 | |
| Pediatric, weight-based | Most use 0.01 mg/kg matches WAO range 0.01 to 0.02 mg/kg, n=128 | |
| Asthma / bronchospasm Adult | Most use 0.3 mg range 0.1 to 0.5 mg, n=98 | |
| Adult, weight-based | All use 0.01 mg/kg n=5 | |
| Pediatric | Most use 0.15 mg range 0.15 to 0.3 mg, n=16 | |
| Pediatric, weight-based | Most use 0.01 mg/kg range 0.01 to 0.02 mg/kg, n=80 | |
| Asystole / PEA Adult | Most use 1 mg matches AHA 2025 range 0.5 to 1 mg, n=7 | |
| Bradycardia Adult | Most use 0.002 mg range 0.001 to 0.006 mg, n=81 | |
| Adult | 0.5 to 1 mL median 0.5, n=6 | |
| Pediatric | Most use 0.01 mg range 0.005 to 0.01 mg, n=6 | |
| Pediatric, weight-based | Most use 0.01 mg/kg matches AHA 2025 range 0.01 to 0.02 mg/kg, n=117 | |
| Cardiac arrest Adult | Most use 1 mg matches AHA 2025 range 0.5 to 2 mg, n=198 | |
| Adult, weight-based | All use 0.01 mg/kg n=5 | |
| Pediatric, weight-based | Most use 0.01 mg/kg matches AHA 2025 range 0.01 to 0.02 mg/kg, n=191 | |
| Cardiogenic shock Adult | Most use 0.01 mg range 0.005 to 0.02 mg, n=5 | |
| CHF / pulmonary edema Adult | 0.002 to 0.01 mg median 0.005, n=5 | |
| Croup Adult | 1 to 3 mg median 1, n=5 | |
| Pediatric | 1 to 5 mg median 3, n=29 | |
| Pediatric | 2.5 to 5 mL median 5, n=11 | |
| Pediatric, weight-based | All use 0.5 mg/kg n=5 | |
| Pediatric, weight-based | Most use 0.5 mL/kg range 0.5 to 1 mL/kg, n=5 | |
| Hypotension / shock Adult | 0.005 to 0.02 mg median 0.01, n=61 | |
| Adult | 0.5 to 1 mL median 1, n=15 | |
| Adult, weight-based | Most use 0.0001 mg/kg range 0.0001 to 0.0001 mg/kg, n=5 | |
| Pediatric | 0.005 to 0.01 mg median 0.01, n=9 | |
| Pediatric, weight-based | 0.0001 to 0.0002 mg/kg median 0.0001, n=30 | |
| Neonatal resuscitation Pediatric, weight-based | Most use 0.01 mg/kg range 0.01 to 0.02 mg/kg, n=18 | |
| Other Adult | Most use 0.3 mg range 0.1 to 0.6 mg, n=56 | |
| Adult | 0.5 to 3 mL median 1, n=15 | |
| Adult, weight-based | 0.0001 to 0.0001 mg/kg median 0.0001, n=9 | |
| Pediatric | 0.1 to 0.5 mg median 0.15, n=26 | |
| Pediatric | 0.5 to 3 mL median 1.75, n=14 | |
| Pediatric, weight-based | Most use 0.01 mg/kg range 0.0075 to 0.02 mg/kg, n=61 | |
| Pediatric, weight-based | Most use 0.1 mL/kg range 0.05 to 0.1 mL/kg, n=8 | |
| Post-ROSC care Adult | Most use 0.01 mg range 0.008 to 0.01 mg, n=5 | |
| Respiratory distress Adult | Most use 0.3 mg range 0.3 to 0.5 mg, n=29 | |
| Pediatric | 0.5 to 1 mg median 1, n=5 | |
| Pediatric, weight-based | All use 0.01 mg/kg n=13 | |
| Sepsis Adult | Most use 0.01 mg range 0.005 to 0.01 mg, n=6 | |
| Pediatric, weight-based | 0.0001 to 0.0001 mg/kg median 0.0001, n=6 | |
| Stridor Adult | 1 to 5 mg median 2, n=13 | |
| Adult | Most use 5 mL range 2.5 to 5 mL, n=9 | |
| Pediatric | 1 to 5 mg median 2, n=16 | |
| Pediatric | 2.5 to 5 mL median 5, n=13 |
Too few protocols to chart yet (protocols in brackets): Beta-blocker / calcium-channel-blocker overdose (1), Burns (1), COPD (3), Cyanide poisoning (2), Head injury / TBI (1), Hypothermia (1), RSI induction (4), Trauma / hemorrhage (4), Traumatic arrest (1), VF / pulseless VT (4)
Doses far off from what other protocols give are likely misreads, so they are left out until checked. How that works.
Named agencies with a page193
Agencies whose protocols are a public record are named here. Their own doses are on their own pages; this list carries no values.
- Academy of Medicine of Cincinnati
- Ada County-City Emergency Services System
- Adams, Benton, Franklin, Yakima Counties
- Alabama Department of Public Health Office of Emergency Medical Services
- Ambulance Victoria
- Anderson County Emergency Medical Services
- Annaville Fire Department
- Arizona Department of Health Services
- Arlington EMS System
- Ashwaubenon Public Safety, Howard Fire Rescue, & De Pere Fire Rescue
- Aurora Fire Rescue
- BC Emergency Health Services
- Benbrook Fire Department
- Berkeley County EMS
- Berrien County Medical Control Authority
- BEST EMS
- Bexar County ESD 4 Fire Rescue
- Bonner County Emergency Medical Services
- Boulder County Protocol Committee
- Brilliant Fire Department
- Brownsville Rural Fire District, Halsey-Shedd Fire Protection District, Jefferson Fire District, Lebanon Fire District, Scio Fire District & Sweet Home Fire & Ambulance District
- Brunswick County EMS
- Cabarrus County EMS
- Calhoun County EMS System
- Campbell County Emergency Medical Service
- Central Arizona Regional EMS
- Central California Emergency Medical Services
- Charleston County EMS
- Chaves County EMS
- Chelan/Douglas/Okanogan/Grant County
- City of Austin / Austin-Travis County EMS System
- Clark County EMS System
- Clark County EMS (Washington)
- Coastal Valleys EMS Agency
- Confederated Tribes of Grand Ronde Department of Emergency Services
- Coos County Emergency Medical Services
- County of San Diego Emergency Medical Services
- Cowlitz County EMS Council
- Craven, Jones, Pamlico Counties EMS
- Dallas Fire-Rescue
- Dane County EMS System
- Davidson County Emergency Services
- Daviess County EMS
- DC Fire and EMS
- Delaware Office of Emergency Medical Services
- Denver Health Paramedic Division
- Department of Aviation Medicine
- Department of Health Services, County of Los Angeles
- Dorchester County EMS
- East Baton Rouge Parish Department of Emergency Medical Services
- El Campo Emergency Medical Service
- El Paso County Emergency Services District #2
- EMS Region VII Bioterrorism and All Hazards Preparedness Committee
- Escambia County Emergency Medical Services
- Evansville Fire Department
- Fairfax County Fire and Rescue Department
- Fern Creek Fire and Emergency Medical Services
- FirstHealth of the Carolinas
- Fort Lauderdale Fire Rescue
- Fort Worth Regional EMS System
- Franklin County Emergency Medical Services
- Galveston Area Ambulance Authority
- Giles County EMS
- Grant County
- Greater Elgin Area EMS System
- Greenville County Emergency Medical Services
- Hays County ESD 9 EMS
- Haywood County EMS System
- Houston Fire Department
- Hunt County EMS
- Idaho EMS Physician Commission
- Illinois Emergency Medical Services for Children
- Illinois Region VIII Emergency Medical Services
- Inland Counties Emergency Medical Agency
- Iowa County Ambulance Service
- Kentucky Board of Emergency Medical Services
- Kern County Public Health
- Kosciusko County Paramedics
- La Porte County Emergency Medical Service
- Lake County Emergency Medical System
- Lake Emergency Medical System
- Lane County Medical Control Board
- Laurens County Emergency Medical Services
- Levy County Department of Public Safety
- Lincoln County EMS
- Louisville Metro EMS
- Maine Emergency Medical Services
- Manatee County Emergency Medical Services
- County of Marin EMS
- Marion County
- Maryland Institute for Emergency Medical Services Systems
- Massachusetts Office of Emergency Medical Services
- Mauston Area Ambulance
- McKinney Fire Department
- Mecklenburg EMS Agency
- MEP (Medical Emergency Partnership) in partnership with SSM Health
- MetroCare Services and Abilene Fire Department
- Michigan Department of Health and Human Services
- Michigan Department of Health and Human Services (MDHHS) / Midland Gladwin MCA
- Michigan Department of Health and Human Services (MDHHS) / West Michigan Regional MCC
- Ministry of Health, Emergency Health Regulatory and Accountability Branch
- Miramar Fire Rescue Department
- Montana Board of Medical Examiners
- Montgomery County Hospital District
- Mountain West Ambulance
- Muskegon County
- Nash County Emergency Medical Services
- National Emergency Medical Services
- Nebraska Medicine Division of Prehospital and Emergency Medical Services
- Nevada EMS Program
- New Hampshire Bureau of Emergency Medical Services
- New Jersey Department of Health
- New Mexico EMS Bureau
- New York State Department of Health, Bureau of Emergency Medical Services and Trauma Systems
- North Carolina Office of Emergency Medical Services (NC OEMS)
- North Central Oregon EMS Agencies
- Northeast Ohio Regional EMS Protocol Committee
- Northeastern Montana Stat Air Ambulance Cooperative
- Northwest Arkansas Regional EMS
- Northwest Community EMS System
- Northwest Region Emergency Medical Services & Trauma Care Council
- Norton Sound Health Corporation
- Nueces County ESD4
- Oakland County Medical Control Authority
- Ocala/Marion County/The Villages Public Safety EMS
- OCEMS
- Office of the EMS Medical Director for Kansas City, Missouri
- Okaloosa County EMS
- Oklahoma State Department of Health
- Old Dominion EMS Alliance, Inc.
- Osage Ambulance District
- Palm Beach Gardens Fire Rescue
- Pend Oreille County Emergency Medical Services
- Peninsulas EMS Council, Inc.
- Pennsylvania Department of Health, Bureau of Emergency Medical Services
- Pettis County Ambulance District
- Pinellas County Emergency Medical Services
- Platte Valley Ambulance Service
- Queensland Ambulance Service
- Rappahannock EMS Council
- Region 1 Emergency Medical Services
- Region 11 Chicago EMS System
- Region 4 EMS
- Region One Metropolitan Ambulance Council
- Region One Metropolitan Ambulance Council (MAC)
- Region X EMS
- Regional Emergency Medical Advisory Committee of New York City
- REMSA
- REMSA Sioux Falls
- Reno County Emergency Medical Services
- Rhode Island Department of Health – Center for Emergency Medical Services
- Richland County Emergency Medical Services
- County of Riverside EMS Agency
- Routt County EMS
- Rowan County Emergency Services EMS Division
- Salem Fire Department
- Salt Lake County EMS
- Santa Barbara County Public Health Department
- Santa Cruz County EMS Agency
- Seattle and King County EMS
- Sierra – Sacramento Valley EMS Agency
- South Carolina Department of Public Health (DPH) Division of EMS
- South Plains Emergency Medical Services
- Southern Fox Valley EMS System
- Spokane County EMS
- St. Johns County Fire Rescue
- Stanislaus County Emergency Medical Services Agency
- Stanly County EMS
- State Board of Emergency Medical, Fire, and Transportation Services
- State of Hawaiʻi Department of Health, Emergency Medical Services & Injury Prevention System Branch
- State of Nebraska
- Stevens County Emergency Medical Services
- Susquehanna Regional EMS
- Tennessee Emergency Medical Services
- The Williamson County EMS System
- Three Rivers Ambulance Authority & Fort Wayne Fire Department
- Thurston County Medic One
- Tidewater Emergency Medical Services Council, Inc.
- Tippecanoe Emergency Ambulance Service
- Tri-County Emergency Medical Control Authority
- Tri County Emergency Medical Services, Inc.
- UNM EMS Consortium
- Utah Department of Public Safety, Bureau of Emergency Medical Services
- UTSW/Parkland BioTel EMS System
- Vermont Department of Health
- Virgin Islands Fire & Emergency Medical Services
- Wake County EMS System
- Washington County Emergency Medical Services
- Washington State Department of Health
- Weber County Paramedic Program
- West Virginia Department of Health, Office of Emergency Medical Services
- Wilson County Emergency Management Agency
- Wilson County ESD #4
Cite this
United States EMS Protocol Census, Epinephrine: n=237 protocols from 199 named agencies / 52 states, as of 2026-10-31