Citation

Mann C, Baer W, Riedel T. Pediatr. Emerg. Care 2019; ePub(ePub): ePub.

Affiliation

From the Kantonsspital Graubünden, Chur, Switzerland.

Copyright

(Copyright © 2019, Lippincott Williams and Wilkins)

DOI

10.1097/PEC.0000000000001766

PMID

30829844

Abstract

Epinephrine plays a controversial role in accidental hypothermia (<30°C). We report its use in the advanced life support of a 13-month-old white girl with pulseless electrical activity and 25°C core body temperature after 32 minutes of submersion in a fast-running Swiss mountain stream at 8°C. Two doses of epinephrine (10 μg/kg) were given in the field, followed by 12 doses (10 μg/kg) and an infusion of 0.1 μg/kg per minute during rewarming. Spontaneous circulation returned at 29.5°C after 2.5 hours of cardiopulmonary resuscitation. Neurologic long-term outcome was excellent. We conclude that in the presence of nonshockable rhythm the benefits of epinephrine may outweigh the risks of side effects when used in pediatric advanced life support for accidental hypothermia.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

Keywords: Drowning; Drowning Prevention; Water Safety

Language: en