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August 1981

Use of Endotracheally Administered Epinephrine in a Pediatric Patient

Author Affiliations

Section of Emergency Medicine The Medical College of Pennsylvania Philadelphia

Am J Dis Child. 1981;135(8):767-768. doi:10.1001/archpedi.1981.02130320075026

During cardiopulmonary resuscitation (CPR), the rapid establishment of intravenous (IV) access is of paramount importance to administer the essential drugs for advanced cardiac life support.1.2 We resuscitated a pediatric patient by the use of an endotracheal route of drug administration.

Report of a Case.—A 13-day-old male infant was brought to the emergency department by police after he had ceased to breathe at home. Proper CPR was administered en route to the hospital. The infant was cyanotic, apneic, and pulseless. The CPR was continued in the emergency department, and endotracheal intubation was immediately achieved with a No. 12 Cole tube. No peripheral IV access was immediately available. Saphenous, umbilical, and brachial cutdowns were attempted without success. An ECG obtained early in the resuscitative effort revealed the child to be in asystole. Epinephrine hydrochloride (0.01 mg) was administered via syringe directly into the endotracheal tube and a manual ventilation

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