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Pediatric emergency care · Apr 1999
Case ReportsPrehospital epinephrine overdose in a child resulting in ventricular dysrhythmias and myocardial ischemia.
- 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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