Digital EpiPen injection: Difference between revisions
| Line 27: | Line 27: | ||
====Equipment Needed==== | ====Equipment Needed==== | ||
10cc syringe | *10cc syringe | ||
*phentolamine | |||
*1-2% lidocaine (WITHOUT epinephrine) | |||
*25g needle | |||
====Technique==== | ====Technique==== | ||
Revision as of 03:26, 29 October 2017
Background
- Accidental digital self-injection of epinephrine from an EpiPen.
Clinical Features
- Puncture wound with delayed capillary refill (vasoconstriction)
Differential Diagnosis
Evaluation
- Typically a clinical diagnosis (no testing required)
Treatment
- Observation for 2 hours after injection[1]
- If continued ischemia symptoms after 2 hrs
- give phentolamine mesylate 1.5mg in 1 mL of lidocaine into the ischemic area
Injection Procedure[2]
Epinephrine induced digital vasospasm using Phentolamine
Indications
For use when epinephrine is accidentally or inappropriately injected
Contraindications
Drug class allergy or non-ischemia.
Equipment Needed
- 10cc syringe
- phentolamine
- 1-2% lidocaine (WITHOUT epinephrine)
- 25g needle
Technique
- Dilute 1.5mg of phentolamine mesilate in 1ml of 2% lidocaine.
- Inject subQ into the site and stop when tissue turns pink again.
- Observe and repeat as necessary.
Disposition
- Outpatient
See Also
References
- ↑ "Six Years of Epinephrine Digital injections: Absence of Significant Local or Systemic Effects." Annals of EM. Sept. 2010. 56(3):p270-274.
- ↑ http://emj.bmj.com/content/21/3/387/