In this section
Definition of terms
Drawing up adrenaline
Drawing up 0.9% Sodium Chloride
The Australian Resuscitation Council recommends the administration of Adrenaline and 0.9% Sodium Chloride bolus as treatment in the event of a cardiac arrest for Basic Life Support (BLS) or Advanced Life Support (ALS). NB-this guideline does not include BLS associated within neonatal inpatients cared for within the Butterfly unit within the Royal Children’s Hospital
The purpose of this clinical guideline is to describe how to draw up and administer intravenous (IV) or intraosseous (IO) adrenaline and fluid in a resuscitation situation.
Adrenaline dosage must be:
(NB:if the above process is leading to any delay in immediate access to adrenaline dose then an initial dose can be drawn from the vial and then the remainder of the vial drawn up as described above).
Figure 1. Example of how to draw up
hypovolaemia is suspected as the cause of cardiorespiratory arrest, intravenous
or intraosseous crystalloid may be used initially for resuscitation] as a bolus
of 20mL/kg. Additional boluses of crystalloid or colloid solution should be
titrated against the response.
(ARC/ANZCOR Guideline 12.4 January 2016). http://resus.org.au/guidelines/
The recommended standard fluid resuscitation dose is 20mL/kg of 0.9%
Sodium Chloride followed by an additional dose if required.
Fluid bolus and volume must be ordered by Medical staff
(initially a verbal order)
Figure 2. Dosifix Burette 3
way tap configuration for Fluid Administration
Tuta hand pump set and 3 way tap configuration and fluid administration
above process is leading to any delay in immediate access to a Fluid bolus then
an initial bolus of 30mL 0.9% Sodium Chloride can
be drawn from the individual plastic saline ampoules with blunt needle until the line is primed and connected to
the patient’s IV\IO or access line and then administered as described above (
see Figure 4).
Figure 4: 30mL syringe with 0.9% Sodium Chloride
Note: Learning Hero and RCH P&Ps are for internal viewing only.
The evidence table for this guideline can be viewed here.
Please remember to read the disclaimer.
The development of this nursing
guideline was coordinated by Jenny Hough, Nurse Educator, Resuscitation Programs, and approved by the Nursing Clinical Effectiveness
Committee. Reviewed February 2020.