Digital EpiPen injection: Difference between revisions
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===Injection Procedure<ref>http://emj.bmj.com/content/21/3/387/</ref>=== | ===Injection Procedure<ref>http://emj.bmj.com/content/21/3/387/</ref>=== | ||
''Epinephrine induced digital vasospasm using Phentolamine'' | ''Epinephrine induced digital vasospasm using Phentolamine'' | ||
====Equipment Needed==== | ====Equipment Needed==== | ||
Revision as of 03:27, 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
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/