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Accidental injection of epinephrine by a child: a unique approach to treatment

Published online by Cambridge University Press:  21 May 2015

Catharine Sellens  and
Laurie Morrison
Catharine Sellens*
Affiliation:
University of Toronto, and Sunnybrook and Women’s College Health Science Centre, Toronto, Ont
Laurie Morrison*
Affiliation:
University of Toronto, and Sunnybrook and Women’s College Health Science Centre, Toronto, Ont
*
PHC.research@utoronto.ca
PHC.research@utoronto.ca

Abstract:

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A 9-year-old girl accidentally injected her right thumb with an adult dose of epinephrine through an auto-injector syringe, delivering 0.3 mg of 1:1000 epinephrine. This injection caused immediate ischemic changes in the digit. This is the first reported case of accidental self injection by a child of an adult dose of epinephrine and its successful treatment with low-dose phentolamine simultaneously infiltrated directly into the puncture area and along the course of the digital artery. The use of phentolamine as a specific competitive alpha-adrenergic antagonist to epinephrine has been well documented in adults and animal models. This report compares the management of a pediatric case to that of all reported adult cases of accidental subcutaneous epinephrine injections. This case suggests a pattern of infiltration with low-dose phentolamine that may be the most effective form of treatment for this condition in a patient of any age.

Type
Pediatrics • Pédiatrie
Information
Canadian Journal of Emergency Medicine , Volume 1 , Issue 1 , April 1999 , pp. 34 - 36
Copyright
Copyright © Canadian Association of Emergency Physicians 1999

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