ArticleBMJ case reports2020
Intravenous epinephrine overdose in prehospital management of suspected anaphylaxis.
Article in BMJ case reports, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Pharmacologic Strategies for Intraoperative Hypotension When Ephedrine Is Unavailable: An Evidence-Based Review.Journal of personalized medicine · 2026Review
- Inappropriate use of intravenous epinephrine leading to atrial fibrillation during prehospital anaphylaxis treatment: a case report.Clinical and experimental emergency medicine · 2024Article
- Frequency of cardiotoxicity following intramuscular administration of epinephrine in emergency department patients with anaphylaxis.Journal of the American College of Emergency Physicians open · 2024Article
- CSACI position statement: transition recommendations on existing epinephrine autoinjectors.Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology · 2021Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
A 65-year-old woman called paramedics for stridor and neck swelling following an insect bite with a possible anaphylactic reaction. On arrival paramedics administered intramuscular epinephrine without any observed improvement in stridor. Paramedics then prepared 5 mg of 1:1000 epinephrine for nebulised administration, which was inadvertently given intravenously. The patient developed tachycardia, anxiety and a severe headache, with biochemical evidence of cardiac necrosis without any haemodynamic compromise. The patient recovered over the next 24 hours and no long-term sequelae were identified on CT coronary angiogram, electrocardiography (ECG) echocardiography or invasive angiography. This case highlights the risk of cardiac ischaemia during epinephrine administration and the importance of protocols to ensure appropriate dosing. This case also raises questions regarding appropriate management of epinephrine overdose and shines a light on the absence of guidelines on the prevention of complications from epinephrine administration.
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