Accidental intravenous administration of racemic adrenaline: two cases associated with adverse cardiac effects

Accidental intravenous administration of racemic adrenaline (epinephrine) is a rare but potentially lethal complication. We describe a case of a 68-year-old man with chronic obstructive pulmonary disease who developed severe dyspnoea at home, and a case of an 81-year-old woman who had an allergic reaction associated with severe dyspnoea. The paramedics accidentally administered racemic adrenaline intravenously in both cases. Both patients suffered from severe cardiac adverse effects but their outcome was eventually favourable. Previous reports of accidental intravenous administration of racemic adrenaline are also reviewed. We discuss the potential risks of using racemic adrenaline, especially in the treatment of geriatric patients, and the possibilities of reducing the risk of accidents in drug administration.