What is the pediatric dose and route of epinephrine for an emergency use auto-injector in a patient who weighs 15–33 kg (33–73 lb)?

• A. 0.3 mg IM for adults
• B. 0.15 mg IV
• C. 0.3 mg IV
• D. 0.15 mg IM for 15–33 kg (33–73 lb)

Answer: (D)

The key idea is that for pediatric anaphylaxis, epinephrine is given using a fixed-dose auto-injector intramuscularly, with the dose chosen by weight. For children in the 15–33 kg range, the standard auto-injector dose is 0.15 mg given into the mid-outer thigh. Intramuscular administration is preferred in the field because it delivers rapid, reliable absorption with a safer profile than intravenous administration. IV epinephrine is reserved for hospital settings under direct medical supervision and carries a higher risk of serious complications, so it isn’t used with auto-injectors in an emergency prehospital/first-aid context. The 0.3 mg IM dose is intended for adults or larger children over about 30 kg, not for this weight range. So the best choice is 0.15 mg IM for a patient weighing 15–33 kg. After administration, call for advanced care and monitor for possible biphasic reactions, repeating dosing as directed by local protocols.