Racemic Epinephrine is on a national shortage in the United States (May 2024)

Racepinephrine (Racemic epinephrine) is used for croup patients who have stridor at rest and post extubation stridor. It is currently on national shortage and many facilities have a very limited supply of the nebules on hand. In times of shortage, intravenous EPINEPHRINE 1 mg/mL can be utilized as a nebulized solution in place of racepinephrine using the dosing of 0.5 mg/kg to a max of 5 mg. Doses that result in a volume of less than 3 mL should have normal saline added to the nebulizer to make a minimum volume of 3 mL.