accidental iv epinephrine

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 regard to intrathecal injection, either intentional or accidental. 2015; 16: 67-70. [7][8] As a medication, it is used to treat a number of conditions, including anaphylaxis, cardiac arrest, asthma, and superficial bleeding. They often, particularly in the case of epinephrine, have catastrophic consequences both for the patient and the well-meaning provider. Reports on accidental intravenous epinephrine overdose in children are extremely rare, although medication errors in the management of pediatric anaphylaxis seem to be frequent. We report a case of a 12-year-old boy presenting with 3 Inappropriate drug use, accidental or otherwise, can pose a great risk. Alexandria Journal of Medicine. The following incident is a medication error case report which illustrates one way that incorrect medication may be administered. Epinephrine, also known as adrenaline, is a medication and hormone. Adrenaline Acid Tartrate 3. International Journal of Cardiology. 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). Catecholamine cardiomyopathy: review and analysis of pathogenetic mechanisms. Journal of Korean Medical Science. Peer review under responsibility of Alexandria University Faculty of Medicine. Michelle, the RN responsible for the accidental IV administration of epinephrine, is a Certified Emergency Nurse with an eighteen-year track record of excellent reviews, four awards for exceptional service, and multiple letters of Accidental hypothermia is a life threatening condition that can lead to a challenging resuscitation. We report two cases of accidental injection of epinephrine into the digits that were successfully treated with subcutaneous phentolamine injection with no adverse events. 1991; 63: 581-591. By continuing you agree to the use of cookies. The following incident is a medication error case report which illustrates one way that incorrect medication may be administered. Hyunseung Koh,Duk Ho Kim,Jinseong Kim,Heebum Yang. [13] Merlo LJ, Singhakant S, Cummings SM, Cottler LB. [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. 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. Journal of Addiction Medicine. Journal Citation Reports/Science Edition Pediatric Emergency Care. 2012; 126: 697-706. Circulation. The device is a single-use system containing a spring-loaded needle which will release 0.15mg or 0 [12] Griggs C, Weiner S, Feldman J. accidental rapid IV epinephrine is known to result in very serious side effects which may include cerebrovascular hemorrhage or cardiac arrhythmias leading to death. 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. … 2021.doi:10.22514/sv.2021.033. Reverse Takotsubo cardiomyopathy in the setting of anaphylaxis treated with high-dose intravenous epinephrine. [15] Son YJ, Lee EK, Ko Y. The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. IndexCopernicus The overall objectives of the Foundation are to promote and develop health education and research programs. The injection caused a drop in blood pressure, pulmonary edema, and cardiac enzyme elevation. Journal of Emergency Medicine. Avoid IV extravasation and accidental injection (e.g., from an auto-injector device). 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. Epinephrine Epinephrine 2014-12-13 00:00:00 Reactions 1531, p84 - 13 Dec 2014 Takotsubo cardiomyopathy: case report A 37-year-old woman developed takotsubo cardiomyopathy following accidental IV administration of epinephrine [adrenaline] for allergic reaction. Accidental Epinephrine Injections Epinephrine auto-injectors are widely used to treat severe allergic reac-tions or anaphylaxis. [2] Brian HR, Brian G. Allergy and anaphylaxis. A physician in a Family Practice training program accidentally injected epinephrine into his left thumb while reading the operating instructions of an autoinjector (Epipen ®). [7] Surineni K, Afzal MR, Barua R, Parashara D. Epinephrine-induced Takotsubo cardiomyopathy. Tintinalli’s emergency medicine: a comprehensive study guide (pp. 2011; 100: 471-473. Scopus is Elsevier's abstract and citation database launched in 2004. 2019; 35: e110-e112. 5.3 Disease Interactions Some patients 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. 2019; 16: 4083. [14] Lee J. Propofol abuse in professionals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). The very young, old, and intoxicated patient are at high risk to developing hypothermia, even in temperate climates. [5] Inhaled epinephrine may be used to improve the symptoms of croup. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences. [4] Khoueiry G, Abi Rafeh N, Azab B, Markman E, Waked A, AbouRjaili G, et al. They often, particularly in the case of epinephrine, have catastrophic consequences both for the patient and the well-meaning provider. Scopus 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. Scopus is Elsevier's abstract and citation database launched in 2004. Our results suggest that 5 microg of epinephrine is not adequate to reliably produce hemodynamic and T-wave alterations in adult pat … While epinephrine is a life-saving drug for many, accidental administration errors pose a risk of lethal heart arrhythmias and have resulted in patient deaths. 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. [6] Taneli Väyrynen MJ, Luurila HO, Määttä TK, Kuisma MJ. 2020; 2: yty043. 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. They often, particularly in the case of epinephrine, have catastrophic consequences both for the patient and the well-meaning provider. 1. ScienceDirect ® is a registered trademark of Elsevier B.V. ScienceDirect ® is a registered trademark of Elsevier B.V. More than 53 million records and 1.18 billion cited references date back from 1900 to present. 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. 2 As such, it’s unlikely to be resolved anytime soon. The treatment of SCMP induced by epinephrine is largely conservative with a symptomatic approach. An alternative explanation is that the associated intravascular administration of epinephrine, which expectedly caused a hypertensive response, disrupted the blood–brain barrier and the defective blood–brain barrier produced sufficient cerebral edema to generate the witnessed symptoms. Accidental injection into the digit from an epinephrine autoinjection device can cause discoloration, pain, and paresthesias. Accidental intravenous administration of racemic adrenaline: two cases associated with adverse cardiac effects. provide readers a transparent and publisher-neutral data & statistics information about the journal. In most cases, the outcome is favorable. They often, particularly in the case of epinephrin… So, an EPINEPH rine autoinjector is appealing as a properly labeled unit dose that can be employed within seconds to treat the emergency, and the contents cannot be administered IV. In: Tintinalli J, Ma O, Yealy DM, et al., (eds.). Upon further evaluation, echocardiography revealed left ventricular wall motion abnormality with reduced ejection fraction. It is also used to treat anaphylaxis caused by unknown [11] Gado A, Ebeid B, Axon A. The proce-dure was terminated and the colonoscope was retrieved. 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. [5] André MC, Hammer J. Life-threatening accidental intravenous epinephrine overdose in a 12-year-old boy. 3 The patient’s symptoms of agitation and loss of consciousness were likely from hypertensive … High levels of circulating epinephrine trigger apical cardiodepression in a β2-adrenergic receptor/Gi-dependent manner: a new model of Takotsubo cardiomyopathy. 2013; 7: 349-353. International Journal of Environmental Research and Public Health. Inappropriate drug use, accidental or otherwise, can pose a great risk. The patient was diagnosed with stress-induced cardiomyopathy (SCMP) and was treated appropriately. More stringent caution should be practiced by medical staff in handling medication to prevent serious medication-related accidents. Symjepi Epinephrine is a key drug used in resuscitation, including advanced life support situations. http://www.signavitae.com/articles/10.22514/sv.2021.033. Science Citation Index Expanded (SciSearch) IV epinephrine was accidentally administered instead of midazolam at colonoscopy. Reasons for misuse of prescription medication among physicians undergoing monitoring by a physician health program. Yale Journal of Biology and Medicine. Although loss of digit is rare, treatment in the emergency department is commonly aimed at vasodilation of the affected tissue. Accidental self-injection of intravenous epinephrine by healthcare personnel. Department of Emergency Medicine, Nowon Eulji Medical Center, Eulji University, Seoul. Accidental IV administration of epinephrine instead of midazolam at colonoscopy. Drug administration errors appear to be a major source of iatrogenic harm to hospitalized patients. This blog will doubtless elicit several comments discussing It works by relaxing the muscles in the airways and tightening the blood vessels. Drug administration errors appear to be a major source of iatrogenic harm to hospitalized patients. 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: heebeom@gmail.com. In most cases, the outcome is favorable. The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). For now, there are more than 58,000 scientific journals registered at ICI. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). 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. Monitor the patient as soon as possible (pulse, blood pressure, ECG, pulse oximetry) in order to assess the response to adrenaline. 68-73). IV epinephrine was accidentally administered instead of midazolam at colonoscopy. Adrenaline 2. European Heart Journal Case Reports. Lidocaine Hydrochloride and Epinephrine Injection contains sodium metabisulfite, a sulfite that may cause allergic-type reactions including anaphylactic symptoms and 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 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. provide readers a transparent and publisher-neutral data & statistics information about the journal. Accidental Injections of Epinephrine (EpiPen) Print Self-administrated shots of epinephrine (often referred to by the brand name EpiPen or epinephrine pen) are life-saving devices which can halt an allergic reaction and give a patient time to get to a hospital. Geneva Foundation for Medical Education and Research European Journal of Emergency Medicine. 2016; 52: 91-93. A case has even been reported with submucosal injection of very low concentrations of 1:100.000 in patients with variant We use cookies to help provide and enhance our service and tailor content and ads. 2013; 27: 1451-1452. 2013; 44: 96-99. [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. Epinephrine Hydrochloride 9. Clinical Research in Cardiology. 2005; 12: 225-229. 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. This debate regarding IV vs. IM epinephrine in anaphylaxis has actually been raging since the turn of the century. Do not inject epinephrine in fingers, toes, nose, and genitalia because it can cause severe tissue necrosis due to vasoconstriction of small blood The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). A 28-year-old nurse inadvertently injected herself with an ampule of epinephrine and was brought to the emergency department. He developed swelling, pallor, and pain in the thumb. 3 cases are reported in the literature in which doses of 1-3.5 mg IV bolus given for mild allergic symptoms lead to patient death 5. 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. discovered. Epinephrine Bitartrate 7. [1] Spina R, Song N, Kathir K, Muller DWM, Baron D. Takotsubo cardiomyopathy following unintentionally large subcutaneous adrenaline injection: a case report. Epinephrine was accidentally administered intravenously instead of midazolam at colonoscopy. 2020; 33: 28-30. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences. Copyright © 2014 The Authors. A 45-year-old man suffered cardiopulmonary arrest in the field, and was treated by ACLS, including the administration of a number of medications through a … 2017; 229: 67- 70. Copyright © 2021 Elsevier B.V. or its licensors or contributors. 2020. Embase May contain additional citric acid and/or sodium citrate for pH adjustment. The error was due to problem with medicine storage, misplaced medication, misreading a medication label and wrong selection. Epinephrine injection is used for emergency treatment of severe allergic reactions (including anaphylaxis) to insect bites or stings, medicines, foods, or other substances. Other disastrous outcomes have occurred in the setting of inadvertent overdose of IV epinephrine including cardiogenic shock, ventricular tachycardia, and severe myocardial ischemia 1. Adrenaline (epinephrine) IV infusion 2016 NMF Consensus Group Adrenaline (epinephrine) IV Infusion Page 1 of 4 This is a printed copy refer to the electronic system for most up to date version Alert 1:10,000 (1 mg/10 mL) ampoule is the preferred preparation for adrenaline infusion. New York: McGraw-Hill Education. Accidental migration of an epidural catheter into a blood vessel is often detected by hemodynamic changes after injecting an epidural test dose containing epinephrine. [8] Paur H, Wright PT, Sikkel MB, Tranter MH, Mansfield C, O’Gara P, et al. The overall objectives of the Foundation are to promote and develop health education and research programs. The treatment of SCMP induced by epinephrine is largely conservative with a symptomatic approach. Treatment included topical … Production and hosting by Elsevier B.V. https://doi.org/10.1016/j.ajme.2014.11.003. The error resulted in intervention (hospital admission and monitoring) but did not result in harm or death. Epinephrine Injection, USP is a sterile, nonpyrogenic solution administered parenterally by the intravenous or intracardiac (left ventricular chamber) routes, or via endotracheal tube into the bronchial tree.Each milliliter (mL) contains epinephrine 0.1 mg; sodium chloride 8.16 mg; sodium metabisulfite added 0.46 mg; citric acid, anhydrous 2 mg and sodium citrate, dihydrate 0.6 mg added as buffers. Epinephrine HCl/D5W 8. Accidental IV administration of epinephrine instead of midazolam at colonoscopy. 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. [10] Jiang JP, Downing SE. Adrenaline Hydrochloride 5. An epinephrine ampoule, 0.25 mg, had been accidentally administered IV instead of midazolam. Epinephrine is in a class of medications called alpha- and beta-adrenergic agonists (sympathomimetic agents). Adrenaline Tartrate 6. Chemical Abstracts Service Source Index In conclusion, our patient report and recent literature reports suggest that USG during performance of nerve blocks does not completely eliminate the risk of accidental intravascular or intraneural9,10injection, and underscores the importance of strict adherence to all safety recommendations regarding the injection of LA during ultrasound-guided regional blocks. 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. Adrenaline Bitartrate 4. Prescription drug monitoring programs: examining limitations and future approaches. Signa Vitae. In 2004, the Institute for Safe Medication Practices reported the death of a The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. Epinephrine; Overdose; Health personnel; Self-administration. For now, there are more than 58,000 scientific journals registered at ICI. 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. 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. Poster Session, August 30, 2012. Federal Practitioner. Western Journal of Emergency Medicine. Epinephrine is a strong vasoconstrictor. 9th edn. Patient assessment showed that all of the symptoms This is a single case report of the accidental intra-arterial injection of epinephrine during a cardiac resuscitation.

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