Epinephrine System Case Studies

Case study: A 52 years old male was admitted to the Emergency room. He was complaining

of shortness of breath and skin rash. He stated that he ate seafood for lunch.

During his examination, his throat was found to be swollen and the sound of his

lungs had a mild stridor upon inspiration. His temperature was 98.8◦F, the blood

pressure was 99/68 mm Hg and he had a pulse of 70 bpm. The patient was

administered with oxygen at 0.5 mg (1:1000). A dose of Epinephrine was

ordered and shortly after he was administrated with the IV infusion of the

epinephrine shortly after he started complaining of chest pain and

tingling sensation on his left arm radiating to his fingertips.

An ECG was ordered and showed an elevated ST,

• Administration errors
• Transcription errors
• Failure to follow proper medical guidelines ( double checking the right drug, doses, routing, time and patient

Epinephrine is a catecholamine that stimulates alpha (α) , beta 1 (β-1) and beta 2

(β-2)adrenergic effector dose dependent. Epinephrine influences its effects on

the heart, vascular and other smooth muscles. It’s usually administrated for both

anaphylaxis and myocardial infarction. Epinephrine is available in different

concentrations and it is administered in a variable type of specific to each

indication.

Doses for Epinephrine Base on Indication:

Indication Dose Administration

Anaphylactic 0.3-0.5mg of 1:1,000 Intramuscular (IM)

Anaphylactic 0.1mg of 1:10,000 IV push over 5 minutes shock Myocardial 1mg of 1:10,000 IV push
Infarction concentration

What could’ve been done by the medical team to prevent these errors?

There are a few aspects related to epinephrine that tends to increase the risk factors of errors in dosing and administrating correctly. The dosage