Some references recommend in children with severe respiratory symptoms to give nebulized epinephrine (usual dose 0.05 mL/kg of 2.25% racemic epinephrine [maximum 0.5 mL] or 0.5 mL/kg of 1:1,000 L-epinephrine [maximum 5 mL])
if good response, observe for 2 hours for recurrence of respiratory symptoms
if poor response or symptoms recur after good response, repeat dose
if poor response or severe respiratory symptoms recur after second dose, admit to intensive care unit.

Some studies conducted for post-extubation stridor in children found that nebulized L-epinephrine demonstrated a lack of dose response in effect on PES and a modestly clinically significant increase in undesired side effects (heart rate and blood pressure) at higher doses.

• da Silva, P.S.L., Fonseca, M.C.M., Iglesias, S.B.O. et al. Nebulized 0.5, 2.5 and 5 ml L-epinephrine for post-extubation stridor in children: a prospective, randomized, double-blind clinical trial. Intensive Care Med 38, 286–293 (2012). https://doi.org/10.1007/s00134-011-2408-9