Fatal intracranial bleeding associated with prehospital use of epinephrine

Annals of Emergency Medicine
B Z HorowitzR W Derlet

Abstract

We present a case of paramedic misjudgment in the execution of a protocol for the treatment of allergic reaction in a case of pulmonary edema with wheezing. The sudden onset of respiratory distress, rash, and a history of a new medicine led the two paramedics on the scene to administer subcutaneous epinephrine. Subsequently, acute cardiac arrest and fatal subarachnoid hemorrhage occurred. Epinephrine has a proven role in cardiac arrest in prehospital care; however, use by paramedics in patients with suspected allergic reaction and severe hypertension should be viewed with caution.

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Citations

Apr 24, 2001·Archives of Disease in Childhood·D J Unsworth
Jan 27, 2007·Annales Françaises D'anesthèsie Et De Rèanimation·P DewachterP-M Mertes
Oct 25, 2011·Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology·Tolly G EpsteinDavid I Bernstein
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Dec 16, 2006·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Gary M VilkeJim Harley
Sep 26, 2006·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Gary M VilkeJim Harley
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Aug 11, 2015·British Journal of Clinical Pharmacology·H Asita de SilvaH Janaka de Silva

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