For a pediatric patient requiring epinephrine 0.01 mg/kg IM, with a maximum dose of 0.3 mg, what is the maximum IM epinephrine dose for a child weighing 20 kg?

• A. 0.2 mg
• B. 0.3 mg
• C. 0.1 mg
• D. 0.25 mg

Answer: (A)

For dosing epinephrine in children, you apply a weight-based calculation first and then check against the maximum single-dose cap. The rule is 0.01 mg per kg IM, with a maximum of 0.3 mg per dose.

For a child weighing 20 kg, the weight-based dose is 0.01 mg/kg × 20 kg = 0.2 mg. This amount is below the 0.3 mg maximum, so the dose you give is 0.2 mg. If you need the injection volume, at a concentration of 1 mg/mL (1:1000), 0.2 mg corresponds to 0.2 mL. The maximum dose only limits you when the weight-based calculation would exceed it; here it does not, so you use the calculated 0.2 mg.