in the spirit of safe practice - i am going to try to explain this-
it is easy to confuse these 2 concentrations - but the key is to remember how they are used in clinical practice. epinephrine is most always a 1mg dose - it just varies with the dilution.
1 mg in 1 ml is always used as a sq medication. it is almost always in a single ml vial, ampoule. this is called 1:1 or 1:1000.
1 mg in 10 ml (of ns) is usually a pre-filled syringe in a boxed container and is given in patient situations that require resuscitation. it is never given except in critical patient situations. this is called 1:10 or 1:10,000.
i think it is more accurate to call it 1:1 (the sq dose) or 1:10 (the resuscitation dose). it just makes it confusing - and these are some who delight in confusion.
subcut or sq - epinephrine is always given as a dose strength of:
1 mg (milligram) in 1 ml.
this is commonly called 1:1 epi or 1:1000 epi. i know it can be confusing. this dose is most commonly found in 1 ml vials or rarely in 30 ml multi-use vials. i have never seen this dose in pre-filled syringes.
but the bottom line: look at the medication - it should note 1 mg in 1 ml.
this dose strength is never diluted for administration.
a typical dose of epi given this was is usually:
0.3 mg and will be 0.3 ml
* (sometimes it may be 0.1 mg/0.1 ml or as much as 0.5 mg/0.5 ml in a single dose)
so, what does this mean? to give subq epi 1:1 you give the portion of the ml that corresponds to the dose. each 0.1 ml or 1/10 of the ml is equal to 0.1 mg or 1/10 of a milligram
use a 1 ml syringe.
always make it easy on yourself. use the most accurate syringe for the medication/route that you have available. i find that when giving partial amounts of a single ml - i always find it easier/more accurate to use a small syringe. draw up the ordered amount of medication.
(don't even try to administer with a 3 ml syringe - it just gets too confusing! - and can decrease your accuracy!)
do not attempt to dilute this and make it complicated.
this is simple medication administration.
after all you do not want to inject a large quantity (fluid) as sq administration. imagine injecting 3 ml as a sq injection. ewwww!
so good rules for med administration that can save you from disaster:
if it takes multiple dilutions, large numbers of vials, unusual amounts to administer (meaning 5 ml as a sq injection - or 40 ml as an iv push) the ordered dose - it is always a good idea to stop.
at this point.
* clarify the order.
* the 5 rights! right now!
so, the short answer is you do not dilute epi for sq administration.
but, rather than just noting that - i though it may be useful to know why/how. i hope this was helpful (and not too confusing).