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[Erroneous intravenous injection of adrenaline]
History And Clinical Findings:
Since a car accident a 29-year-old man had been suffering from chronic pain treated with injections of morphine and tilidine. Because of renewed worsening of pain he went to the emergency doctor who by mistake intravenously injected 1 mg of undiluted adrenaline. The patients immediately collapsed and pulmonary oedema developed.
Investigations:
On admission he was hypotensive (85/45 mmHg) and tachycardic (135/min), respiratory rate 36/min. Moist rales were heard throughout the lung. The white cell count was elevated and serum potassium low (3.5 mmol/l). but other routine laboratory tests were unremarkable.
Treatment And Course:
Furosemide, nitroglycerin and morphine were injected at once and his general state improved over the subsequent few hours. Chest radiogram on the next day demonstrated marked reduction of the pulmonary oedema.
Conclusion:
To prevent similar, potentially lethal, accidents, before every i.v. injection two persons should check the name of the drug on the label of the vial or bottle, both on drawing up and before injecting the drug.