Digital EpiPen injection: Difference between revisions
(Text replacement - "==Treatment==" to "==Management==") Tag: mobile edit |
|||
| Line 14: | Line 14: | ||
*Typically a clinical diagnosis (no testing required) | *Typically a clinical diagnosis (no testing required) | ||
== | ==Management== | ||
*Observation for 2 hours after injection<ref>"Six Years of Epinephrine Digital injections: Absence of Significant Local or Systemic Effects." Annals of EM. Sept. 2010. 56(3):p270-274. | *Observation for 2 hours after injection<ref>"Six Years of Epinephrine Digital injections: Absence of Significant Local or Systemic Effects." Annals of EM. Sept. 2010. 56(3):p270-274. | ||
</ref> | </ref> | ||
Revision as of 07:57, 12 December 2017
Background
- Accidental digital self-injection of epinephrine from an EpiPen.
Clinical Features
- Puncture wound with delayed capillary refill (vasoconstriction)
Differential Diagnosis
- Injection of other medication
- Retained foreign body
- Allergic reaction
- Cellulitis
Evaluation
- Typically a clinical diagnosis (no testing required)
Management
- Observation for 2 hours after injection[1]
- If continued ischemia symptoms after 2 hrs, inject phentolamine into the ischemic area (see procedure below)
Digital Phentolamine Injection Procedure[2]
Equipment Needed
- 10cc syringe
- Phentolamine mesylate
- 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/