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Stephen C. Kurachek, MD; Mark A. Rockoff, MD

JAMA. 1985;253(10):1441-1442.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

NEBULIZED racemic epinephrine is used to relieve respiratory distress in patients with upper airway edema caused by prior endotracheal intubation or laryngotracheobronchitis (croup). Although side effects are uncommon when the drug is used as recommended, a recent report discussed complications that arose when racemic epinephrine was accidentally administered orally to small infants.¹ Our report describes the consequences of an inadvertent intravenous administration of this medication and the potential hazard of withdrawing nonparenteral medications from their containers by syringe.

Report of a Case

A 13-month-old, 8.6-kg infant was hospitalized with clinical and radiographic evidence of croup. Progressive respiratory distress prompted transfer to the intensive care unit the following day. When the infant developed cyanosis and bradycardia during a coughing episode, preparations for endotracheal intubation were begun. Nebulized racemic epinephrine (0.25 mL of 2.25% racemic epinephrine in 2.0 mL of normal saline) had been administered with oxygen eight times during the . . . [Full Text PDF of this Article]

Author Affiliations
From the Department of Anesthesia, Harvard Medical School and Children's Hospital, Boston.

Footnotes
Reprint requests to Children's Hospital, 300 Longwood Ave, Boston, MA 02115 (Dr Rockoff).

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