Push-dose epinephrine in adults is delivered as 1 mL every 1 to 5 minutes with titration to maintain systolic blood pressure above what value?

• A. 70 mm Hg
• B. 80 mm Hg
• C. 90 mm Hg
• D. 100 mm Hg

Answer: (C)

Push-dose epinephrine is used to rapidly support blood pressure in adults with acute hypotension, delivered in small IV boluses and titrated to a systolic BP that preserves organ perfusion without causing excessive hypertension. The target here is to keep systolic blood pressure above 90 mm Hg. This level provides enough cerebral and coronary perfusion in many patients while avoiding the risks of pushing pressures too high. Thresholds as low as 70–80 mm Hg could allow inadequate perfusion in shock, and going up to around 100 mm Hg may unnecessarily increase afterload and cardiac work. Continuous monitoring and adjustment guide the dosing to maintain that SBP above 90.