I could not find data about this issue and asked Dr. Kevin Kelly to weigh in on the topic. I am grateful to him for his response which follows.
I am unaware of any data to support this reduction in dose. The practice parameter certainly hedges everyone’s bet. Personally, I believe an insufficient dose of epinephrine is a problem and the actual dosing range usually quoted is 0.3-0.5 ml. The autoinjector epinephrine doses are at the starting dose. Ultimately, there is no right or wrong answer except that the use of intravenous epinephrine would not be recommended.
I hope this information is helpful.
Jacqueline A. Pongracic, MD, FAAAAI