Wrong dosage on Adrenaline

I'm a fresh graduated nurse appointed into a hospital emergency department 9 months ago. The department can receive 80+ ambulance cases with walk in patients up to 130+ cases per day!

Recently I attended to a case brought in by paramedic. Patient, Mdm C developed severe rashes over the body with wheezing sounds heard upon breathing.

It's an allergic reaction, paramedic and I brought patient to the resuscitation site without hesitation. BP cuff and SPO2 probe was put up, with 15L of oxygen delivered through non-rebreather mask, the best I could do while waiting for doctor to review.

Medical Officer A came and attended to Mdm C. She tried to cannulate, difficult vein as patient developed hives over the upper limbs and body trunk.

"Give IM Adrenaline" Medical Registrar B mentioned.

"The 1:1000 unit adrenaline?" I replied.

"Yes please" as replied by the MR B.

I broke the ampoule and withdrawed the drug, 1:1000 unit or equivalent to 1ml : 1mg of adrenaline.

MR B attended to other patients while MO A and I stayed with Mdm C, wheezing sound becoming louder and louder, she's in distress.

It's the medication in my hand which will reverse the situation, it's gonna be a difficult airway for intubation if she collapsed, I told myself.

MO A struggled, finally got a site and was obtaining blood specimens. I reconfirmed with her the total dosage of adrenaline to be served to patient, it was my first time giving the IM Adrenaline.

"To serve 1:1000 unit equivalent to 1mg of adrenaline doc?" I said.

"Yes please, I heard the order informed is 1:1000 unit" replied the MO A.

Before the needle touch the patient, I recheck."1:1000 unit equivalent to 1mg of adrenaline, yes doc?" I asked.

"Yes please serve" replied the MO A.

I did not query more, patient was in distress with worsening wheezing sounds, the doc might need to increase the adrenaline dosage in view of the situation. I trusted the MO A, she should have knowledge in handling anaphylaxis.

After the drug is given, patient turned well. Hives gone wheezing sound subsided.

I'd done a great job, complimenting myself

I then approached a computer, time to acknowledged the medication I'd served.

[Adrenaline Autoinjector 0.3ml / 0.3mg]

I stunned after reading the prescription.

It's not something I'd heard from the MR B, not from the MO A too, I alerted MO A regarding the order, she said she heard 1:1000 unit of adrenaline and she will clarify the issue for me.

MR B then came, I query her regarding the order, she shocked, asking me why didn't I query someone more senior if I was not sure regarding the dosage to be served.

It was a medication error.

It was a tragic to me, a bad experience for a fresh graduate nurse like me. Incident report was made, I would not want patient to be in life treathening situation, I recheck the parameter every 5 minutes making sure that she's fine.

By then my nurse clinician gave me a hard time, questioning me why didn't I recheck dosage with MR B, why would I trust MO A regarding the dosage, why didn't I call pharmacy regarding the dosage, is the situation so desperate that I had to serve the IM Adrenaline? Warning letter was given and I am not allowed to serve any medication until 3 months later.

I felt so bad regarding the situation, I was trying to help, trying to save a life, of course I don't mean to conduct the medication error, I just feel like leaving nursing once and for all.