Hey folks Scott Weingard here and this is an Emcret We on Dirty Eppy or Adhoc bedside Epinephyrin drips.

Now let's first explain what Dirty Eppy is.

I believe the name was coined by Ferenemy of the show,

Ruben Strayer, on his EM updates blog. It was a practice that had been going on for years in emergency

medicine, these ad hoc mixings of epinephrine, but he had coined the name that stuck, dirty epi. And what this is you

take 1 milligram of epinephrine. It could be in the 1 milligram per

male form or the 1 milligram in 10

millil form it really just doesn't matter that much you just take any form of a

milligram of at the and you put it into a thousand c c c. C.'s of normal saline.

Or really, whatever IV food you have,

but I know it's compatible with normal saline.

You stick it in there, and now you have for all intents and purposes, regardless of which form you used,

one microgram per ML of epinephrine.

Now, in true dirty epi fashion, you would then put it on a standard ED drip set without a pump and

start running it in and you could either just run it in as fast as it could go in a patient who's

crashing hoping that dose will be within a normal dose range it probably winds up in depending on which IV canyals

you have somewhere in the 20 to 30 microgram per minute range which is it's high or

you could look at the drips the drops coming out of that drip set and make some calculations in your head to how much epi they're actually getting and titrate thereby accordingly.

Now, I've in the past and right now have no shame whatsoever

in saying this is really just a dumb idea.

This is a dumb, dumb idea to do dirty epi. And beyond being dumb, it's inelegant.

It just makes us look like clods, right? It just this is cave person medicine and the reason Rubin has put this is cave person

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