Prehospital epinephrine overdose in a child resulting in

Pediatric emergency care · Apr 1999

Case Reports

Prehospital epinephrine overdose in a child resulting in ventricular dysrhythmias and myocardial ischemia.

Epinephrine overdoses in children have been associated with supraventricular tachycardia. Myocardial ischemia subsequent to epinephrine overdose has not been reported in pediatric patients. ⋯ There is no role for high-dose epinephrine in the treatment of allergic reactions or asthma. Careful epinephrine dosing, using mg/kg and verifying the volume, dilution, and route of administration is essential to prevent epinephrine toxicity.

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- C O Davis and P M Wax.
- Department of Emergency Medicine, University of Rochester, New York 14462, USA. colleen_davis@urmc.rochester.edu
- Pediatr Emerg Care. 1999 Apr 1;15(2):116-8.
IntroductionEpinephrine overdoses in children have been associated with supraventricular tachycardia. Myocardial ischemia subsequent to epinephrine overdose has not been reported in pediatric patients.Case ReportWe report a case of ventricular dysrhythmias and myocardial ischemia in a 5-year-old boy who received 10 times the recommended dose of subcutaneous epinephrine. Prehospital providers administered the epinephrine, believing it was part of a "high-dose" epinephrine protocol.DiscussionThere is no role for high-dose epinephrine in the treatment of allergic reactions or asthma. Careful epinephrine dosing, using mg/kg and verifying the volume, dilution, and route of administration is essential to prevent epinephrine toxicity.

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Prehospital epinephrine overdose in a child resulting in ventricular dysrhythmias and myocardial ischemia.

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