Avoid IV extravasation and accidental injection (e.g., from an auto-injector device). 2019; 16: 4083. This blog will doubtless elicit several comments discussing The overall objectives of the Foundation are to promote and develop health education and research programs. Epinephrine; Overdose; Health personnel; Self-administration. [9] Nazir S, Lohani S, Tachamo N, Ghimire S, Poudel DR, Donato A. Takotsubo cardiomyopathy associated with epinephrine use: a systematic review and meta-analysis. Upon further evaluation, echocardiography revealed left ventricular wall motion abnormality with reduced ejection fraction. Epinephrine injection is used along with emergency medical treatment to treat life-threatening allergic reactions caused by insect bites or stings, foods, medications, latex, and other causes. A 28-year-old nurse inadvertently injected herself with an ampule of epinephrine and was brought to the emergency department. Accidental self-injection of intravenous epinephrine by healthcare personnel. Chemical Abstracts Service Source Index 68-73). 2 As such, it’s unlikely to be resolved anytime soon. In: Tintinalli J, Ma O, Yealy DM, et al., (eds.). The patient was diagnosed with stress-induced cardiomyopathy (SCMP) and was treated appropriately. Science Citation Index Expanded (SciSearch) More than 53 million records and 1.18 billion cited references date back from 1900 to present. Epinephrine, also known as adrenaline, is a medication and hormone. The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. We report two cases of accidental injection of epinephrine into the digits that were successfully treated with subcutaneous phentolamine injection with no adverse events. International Journal of Cardiology. Embase Journal of Addiction Medicine. Adrenaline (epinephrine) IV infusion Newborn use only 2020 ANMF consensus group Adrenaline (epinephrine) IV infusion Page 1 of 3 Alert 1:10,000 (1 mg/10 mL) ampoule is the preferred preparation for adrenaline infusion. [7] Surineni K, Afzal MR, Barua R, Parashara D. Epinephrine-induced Takotsubo cardiomyopathy. 2020. Monitor the patient as soon as possible (pulse, blood pressure, ECG, pulse oximetry) in order to assess the response to adrenaline. The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications. Journal of Anesthesia, Intensive Care, Emergency and Pain Medicine, Accidental self-injection of intravenous epinephrine by healthcare personnel, 1Department of Emergency Medicine, Nowon Eulji Medical Center, Eulji University, Seoul, Republic of Korea, *Corresponding Author(s): Heebum Yang E-mail: [email protected]. Inappropriate drug use, accidental or otherwise, can pose a great risk. Journal of Emergency Medicine. Signa Vitae. We use cookies to help provide and enhance our service and tailor content and ads. Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug. After a short stay in the intensive care unit as the vital signs were affected, the patient was transferred to the ward on the second day of hospitalization and was well enough to be discharged on the fifth day. 1991; 63: 581-591. Department of Emergency Medicine, Nowon Eulji Medical Center, Eulji University, Seoul. [7][8] As a medication, it is used to treat a number of conditions, including anaphylaxis, cardiac arrest, asthma, and superficial bleeding. During transfer of haemodynamically unstable patients with limited staffing and resources on site, a peripheral vasopressor infusion is sometimes resorted to as a temporary measure of optimising haemodynamic parameters. High levels of circulating epinephrine trigger apical cardiodepression in a β2-adrenergic receptor/Gi-dependent manner: a new model of Takotsubo cardiomyopathy. Adrenaline 2. The injection caused a drop in blood pressure, pulmonary edema, and cardiac enzyme elevation. Epinephrine was accidentally administered intravenously instead of midazolam at colonoscopy. Western Journal of Emergency Medicine. http://www.signavitae.com/articles/10.22514/sv.2021.033. They often, particularly in the case of epinephrine, have catastrophic consequences both for the patient and the well-meaning provider. Still, we agree with NCCN that the presence of a vial or ampul of EPINEPHrine in the wrong hands invites accidental IV injection when the patient has an IV line established. For now, there are more than 58,000 scientific journals registered at ICI. Peer review under responsibility of Alexandria University Faculty of Medicine. 5.3 Disease Interactions Some patients [15] Son YJ, Lee EK, Ko Y. In most cases, the outcome is favorable. provide readers a transparent and publisher-neutral data & statistics information about the journal. Do not inject epinephrine in fingers, toes, nose, and genitalia because it can cause severe tissue necrosis due to vasoconstriction of small blood The IV route for injection of epinephrine must be used with extreme caution and is best reserved for specialists familiar with IV use of epinephrine (adrenaline). More stringent caution should be practiced by medical staff in handling medication to prevent serious medication-related accidents. More than 53 million records and 1.18 billion cited references date back from 1900 to present. [5] André MC, Hammer J. Life-threatening accidental intravenous epinephrine overdose in a 12-year-old boy. Catecholamine cardiomyopathy: review and analysis of pathogenetic mechanisms. Accidental injection into the digits, hands or feet may result in loss of blood flow to the affected area and has been associated with tissue necrosis. [13] Merlo LJ, Singhakant S, Cummings SM, Cottler LB. regard to intrathecal injection, either intentional or accidental. The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications. Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. 2013; 7: 349-353. The treatment of SCMP induced by epinephrine is largely conservative with a symptomatic approach. By continuing you agree to the use of cookies. 2011; 100: 471-473. Drug administration errors appear to be a major source of iatrogenic harm to hospitalized patients. Epinephrine Bitartrate 7. Yale Journal of Biology and Medicine. The error was due to problem with medicine storage, misplaced medication, misreading a medication label and wrong selection. Adrenaline Hydrochloride 5. Although loss of digit is rare, treatment in the emergency department is commonly aimed at vasodilation of the affected tissue. provide readers a transparent and publisher-neutral data & statistics information about the journal. 2017; 229: 67- 70. Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and Reports on accidental intravenous epinephrine overdose in children are extremely rare, although medication errors in the management of pediatric anaphylaxis seem to be frequent. 1. The epinephrine injection, USP auto-injector is indicated in the emergency treatment of allergic reactions (Type I) including anaphylaxis to stinging insects and biting insects, allergen immunotherapy, foods, drugs, diagnostic testing substances, and other allergens, as well as idiopathic anaphylaxis or exercise-induced anaphylaxis. Production and hosting by Elsevier B.V. https://doi.org/10.1016/j.ajme.2014.11.003. Epinephrine is in a class of medications called alpha- and beta-adrenergic agonists (sympathomimetic agents). More stringent caution should be practiced by medical staff in handling medication to prevent serious medication-related accidents. This debate regarding IV vs. IM epinephrine in anaphylaxis has actually been raging since the turn of the century. Scopus is Elsevier's abstract and citation database launched in 2004. Geneva Foundation for Medical Education and Research It is also used to treat anaphylaxis caused by unknown IV epinephrine was accidentally administered instead of midazolam at colonoscopy. European Journal of Emergency Medicine. [1] Spina R, Song N, Kathir K, Muller DWM, Baron D. Takotsubo cardiomyopathy following unintentionally large subcutaneous adrenaline injection: a case report. accidental IV epinephrine that have caused coronary vasospasm (1), angina (2) or even acute MI (Ref). Association of working hours and patient safety competencies with adverse nurse outcomes: a cross-sectional study. Reverse Takotsubo cardiomyopathy in the setting of anaphylaxis treated with high-dose intravenous epinephrine. The manuscript was previously presented as a poster in the 14th International Congress of the Egyptian Society of Hepatology, Gastroenterology and Infectious Diseases in Alexandria. 9th edn. Accidental IV administration of epinephrine instead of midazolam at colonoscopy. [14] Lee J. Propofol abuse in professionals. Accidental injection into the digit from an epinephrine autoinjection device can cause discoloration, pain, and paresthesias. In 2004, the Institute for Safe Medication Practices reported the death of a Epinephrine is a strong vasoconstrictor. Copyright © 2021 Elsevier B.V. or its licensors or contributors. The error resulted in intervention (hospital admission and monitoring) but did not result in harm or death. Epinephrine injection is used for emergency treatment of severe allergic reactions (including anaphylaxis) to insect bites or stings, medicines, foods, or other substances. May contain additional citric acid and/or sodium citrate for pH adjustment. [4] Khoueiry G, Abi Rafeh N, Azab B, Markman E, Waked A, AbouRjaili G, et al. [12] Griggs C, Weiner S, Feldman J. [2] Brian HR, Brian G. Allergy and anaphylaxis. Inappropriate drug use, accidental or otherwise, can pose a great risk. The following incident is a medication error case report which illustrates one way that incorrect medication may be administered. 2020; 33: 28-30. An epinephrine ampoule, 0.25 mg, had been accidentally administered IV instead of midazolam. Lidocaine Hydrochloride and Epinephrine Injection contains sodium metabisulfite, a sulfite that may cause allergic-type reactions including anaphylactic symptoms and … Accidental Epinephrine Injections Epinephrine auto-injectors are widely used to treat severe allergic reac-tions or anaphylaxis. Scopus Vasoactive agents should be administered through a controlled well-marked infusor pump, ideally via a central venous catheter if given over longer periods of time. Journal Citation Reports/Science Edition [3] Härle T, Kronberg K, Nef H, Möllmann H, Elsässer A. Inverted Takot-subo cardiomyopathy following accidental intravenous administration of epinephrine in a young woman. The following incident is a medication error case report which illustrates one way that incorrect medication may be administered. Other disastrous outcomes have occurred in the setting of inadvertent overdose of IV epinephrine including cardiogenic shock, ventricular tachycardia, and severe myocardial ischemia 1.
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