{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T16:34:42Z","timestamp":1784565282762,"version":"3.55.0"},"reference-count":14,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,12,3]]},"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:p>A 65-year-old woman called paramedics for stridor and neck swelling following an insect bite with a possible anaphylactic reaction. On arrival paramedics administered intramuscular epinephrine without any observed improvement in stridor. Paramedics then prepared 5\u2009mg of 1:1000 epinephrine for nebulised administration, which was inadvertently given intravenously. The patient developed tachycardia, anxiety and a severe headache, with biochemical evidence of cardiac necrosis without any haemodynamic compromise. The patient recovered over the next 24\u2009hours and no long-term sequelae were identified on CT coronary angiogram, electrocardiography (ECG) echocardiography or invasive angiography. This case highlights the risk of cardiac ischaemia during epinephrine administration and the importance of protocols to ensure appropriate dosing. This case also raises questions regarding appropriate management of epinephrine overdose and shines a light on the absence of guidelines on the prevention of complications from epinephrine administration.<\/jats:p>","DOI":"10.1136\/bcr-2019-232654","type":"journal-article","created":{"date-parts":[[2020,1,9]],"date-time":"2020-01-09T04:55:24Z","timestamp":1578545724000},"page":"e232654","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Intravenous epinephrine overdose in prehospital management of suspected anaphylaxis"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9666-9184","authenticated-orcid":false,"given":"Jack","family":"Callum","sequence":"first","affiliation":[{"name":"General Medicine, Metro North Hospital and Health Service, Redcliffe, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myles","family":"Rivlin","sequence":"additional","affiliation":[{"name":"General Medicine, Metro North Hospital and Health Service, Redcliffe, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Carroll","sequence":"additional","affiliation":[{"name":"General Medicine, Metro North Hospital and Health Service, Redcliffe, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,1,8]]},"reference":[{"key":"2025082723371762000_13.1.e232654.1","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.1111\/cea.12748","article-title":"Increases in anaphylaxis fatalities in Australia from 1997 to 2013","volume":"46","author":"Mullins","year":"2016","journal-title":"Clin Exp Allergy"},{"key":"2025082723371762000_13.1.e232654.2","doi-asserted-by":"crossref","first-page":"1169","DOI":"10.1016\/j.jaip.2017.06.031","article-title":"Fatal anaphylaxis: mortality rate and risk factors","volume":"5","author":"Turner","year":"2017","journal-title":"J Allergy Clin Immunol Pract"},{"key":"2025082723371762000_13.1.e232654.3","unstructured":"Crossman M . 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