Intracranial Hemorrhage After Prehospital Administration of Intramuscular Epinephrine

Abstract Background The administration of epinephrine by the intramuscular route can be life-saving in cases of anaphylaxis or severe allergic reactions. However, the use of this drug can lead to a rapid rise in blood pressure, which theoretically could lead to deleterious effects in patients of any...

Full description

Saved in:
Bibliographic Details
Published in:The Journal of emergency medicine 2011-06, Vol.40 (6), p.e107-e110
Main Authors: Levis, Joel T., MD, PHD, Ford, Jonathan B., MD, Kuo, Albert M., MD
Format: Article
Language:English
Subjects:
Adrenergic alpha-Agonists - administration & dosage
Adrenergic alpha-Agonists - adverse effects
Adrenergic beta-Agonists - administration & dosage
Adrenergic beta-Agonists - adverse effects
Aged
Anaphylaxis
Blood pressure
Case reports
Drugs
elderly
Emergency
emergency department
Epinephrine
Epinephrine - administration & dosage
Epinephrine - adverse effects
evacuation
Female
Geriatrics
Hematoma
Hemorrhage
Humans
Hymenoptera
Hypersensitivity
Injections, Intramuscular
Insect Bites and Stings - drug therapy
intracranial hemorrhage
Intracranial Hemorrhage, Hypertensive - chemically induced
Intracranial Hemorrhage, Hypertensive - diagnostic imaging
Intracranial Hemorrhage, Hypertensive - surgery
intramuscular
Radiography
Respiratory tract
Stings
Tongue
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Background The administration of epinephrine by the intramuscular route can be life-saving in cases of anaphylaxis or severe allergic reactions. However, the use of this drug can lead to a rapid rise in blood pressure, which theoretically could lead to deleterious effects in patients of any age, with elderly patients at greatest risk. Objectives To present a rare case of intracranial hemorrhage potentially resulting from the administration of intramuscular epinephrine in an elderly patient with an allergic reaction. Case Report We present a case report of a 65-year-old woman who developed an intracranial hemorrhage after a single, therapeutic, intramuscular dose of epinephrine for a wasp sting to the tongue. The patient underwent successful craniotomy with evacuation of the intracranial hematoma. Conclusions In circumstances where the severity of the allergic reaction remains unclear (lack of airway compromise, cardiovascular collapse, or true anaphylaxis), careful consideration of the potential risks of intramuscular epinephrine, such as a rapid rise in blood pressure leading to intracranial hemorrhage, should be undertaken when using this medication in elderly patients.
ISSN:0736-4679
2352-5029
DOI:10.1016/j.jemermed.2008.01.008