Liew Pui Yi Lily, Craven John Andrew
Department of Emergency Medicine, Flinders Medical Centre, Flinders Drive, Bedford Park, 5042, Adelaide, Australia.
Present address: Department of Obstetrics and Gynaecology, Monash Health, Casey Hospital, 62-70 Kangan Drive, Berwick, 3806, Victoria, Australia.
J Med Case Rep. 2017 May 8;11(1):129. doi: 10.1186/s13256-017-1290-7.
Adrenaline is the standard treatment for anaphylaxis but appropriate administration remains challenging, and iatrogenic overdose is easily overlooked. Despite the established importance of pediatric blood pressure measurement, its use remains inconsistent in clinical practice.
We report a case of adrenaline overdose in a 9-year-old white boy with anaphylaxis, where signs of adrenaline overdose were indistinguishable from progressive shock until blood pressure measurement was taken.
The consequences of under-dosing adrenaline in anaphylaxis are well-recognized, but the converse is less so. Blood pressure measurement should be a routine part of pediatric assessment as it is key to differentiating adrenaline overdose from anaphylactic shock.
肾上腺素是治疗过敏反应的标准药物，但正确给药仍具有挑战性，医源性用药过量很容易被忽视。尽管小儿血压测量的重要性已得到确立，但其在临床实践中的应用仍不一致。
我们报告一例9岁白人男孩因过敏反应导致肾上腺素过量的病例，在测量血压之前，肾上腺素过量的体征与进行性休克难以区分。
过敏反应中肾上腺素剂量不足的后果已得到充分认识，但反之则不然。血压测量应作为儿科评估的常规部分，因为它是区分肾上腺素过量与过敏性休克的关键。
