title: Prehospital epinephrine overdose in a child resulting in ventricular dysrhythmias and myocardial ischemia.
abstract: BACKGROUND
  Epinephrine overdoses in children have been associated with supraventricular tachycardia. Myocardial ischemia subsequent to epinephrine overdose has not been reported in pediatric patients.
  
  
  METHODS
  We 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Emergency Medicine, University of Rochester, New York 14462, USA. colleen_davis@urmc.rochester.edu
authors.forename: C O
authors.initials: CO
authors.lastname: Davis
authors.forename: P M
authors.initials: PM
authors.lastname: Wax
mesh_terms: D000293:Adolescent; D000322:Adrenergic Agonists / Q000506:poisoning* / Q000627:therapeutic use; D000328:Adult; D001249:Asthma / Q000188:drug therapy; D002675:Child, Preschool; D002985:Clinical Protocols; D062787:Drug Overdose; D004632:Emergency Medical Services / Q000592:standards; D004837:Epinephrine / Q000506:poisoning* / Q000627:therapeutic use; D006801:Humans; D006967:Hypersensitivity / Q000188:drug therapy / Q000209:etiology; D007223:Infant; D008297:Male; D008508:Medication Errors; D017202:Myocardial Ischemia / Q000139:chemically induced*; D017180:Tachycardia, Ventricular / Q000139:chemically induced*
chemical_list: D000322:Adrenergic Agonists; D004837:Epinephrine