We currently have an Epi/Cal drip in our formulary (epinephrine 4mg + CaCl 1gm / 250mL D5W). Our maximum rate is 20mL/hr (~5.333mcg/min of epinephrine). Our plain epinephrine drips (various concentrations) have a max rate of 50 mcg/min.

#1: If you currently use EPI/CAL, what evidence/references do you use to support its continued use? -1990's article in Circulation showed that "calcium blunts epinephrine's beta-adrenergic actions in postoperative cardiac surgery patients." We would like to use this article as a foundation for having EPI/CAL removed from formulary.

Hello ~
(two questions coming to you today!)

First is this (in light of the epi auto-injector shortage):
In your Ambulatory/Outpatient spaces (if you have oversight) - do you currently stock EpiPens (or the generic auto-injectors) or do you supply epinephrine anaphylaxis kits (with the vial and instructions for dosing)?

Would you be willing to share your kit / label design and any additional safety measures / training that you have in place for staff, if you are currently stocking providing epi kits to the clinics?