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A female patient presented with respiratory depression secondary to opioid overdose, requiring emergent intubation. Shortly after intubation, she developed severe bronchospasm unresponsive to standard therapies including inhaled beta-agonists, intravenous corticosteroids, intramuscular epinephrine and sedation. As a last-resort intervention, 0.5 mg of epinephrine 1:10 000 in 10 mL normal saline was administered via the endotracheal tube, resulting in immediate clinical improvement in oxygen saturation and airway pressures. The purpose of this report is to describe the utilisation of 0.5 mg of epinephrine 1:10 000 in 10 mL normal saline given endotracheally for unanticipated post-intubation bronchospasm. The findings of this case support the idea that the endotracheal administration may be beneficial in the intubated patient with severe bronchospasm that is refractory to more traditional treatments.<\/jats:p>","DOI":"10.1136\/bcr-2025-266826","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T16:20:20Z","timestamp":1768839620000},"page":"e266826","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Use of endotracheal epinephrine for refractory unanticipated post-intubation bronchospasm"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6150-8110","authenticated-orcid":false,"given":"Nada","family":"Saleh","sequence":"first","affiliation":[{"name":"Internal Medicine, Mercyhealth Hospital Rockton Avenue, Rockford, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yone","family":"Amuka","sequence":"additional","affiliation":[{"name":"Javon Bea Hospital - Rockton, Rockford, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Wistrom","sequence":"additional","affiliation":[{"name":"Javon Bea Hospital - Rockton, Rockford, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,1,19]]},"reference":[{"key":"2026011908201069000_19.1.e266826.1","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1113\/jphysiol.1949.sp004431","article-title":"On the actions of noradrenaline, adrenaline and isopropyl noradrenaline on the arterial blood pressure, heart rate and muscle blood flow in man","volume":"110","author":"BARCROFT","year":"1949","journal-title":"J Physiol"},{"key":"2026011908201069000_19.1.e266826.2","unstructured":"Belcher Pharmaceuticals . 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