Several studies1have shown that nebulized racemic epinephrine, which stimulates both α-adrenergic and β-adrenergic receptors, is as effective or superior to albuterol in relieving airway obstruction in patients with viral bronchiolitis. Some studies2–3 have shown no significant difference in the effectiveness of nebulized therapy with epinephrine and albuterol in a hospital setting. But short-term benefits in respiratory rate, oxygen saturation, and clinical score have been observed with the use of epinephrine. A single outpatient, placebo-controlled trial4noted a statistically insignificant but potentially clinically meaningful 12% decrease in the hospitalization rate in the epinephrine group. One study5 in an ED showed that patients treated with epinephrine were discharged significantly earlier than patients who had been treated with albuterol.