High-pressure injection injury: Difference between revisions
No edit summary |
|||
| Line 14: | Line 14: | ||
==Treatment== | ==Treatment== | ||
*Emergent ortho consult | |||
*Early surgical decompression and debridement | *Early surgical decompression and debridement | ||
**>10hours to OR with increased amp rates | |||
*Immobilize and elevate affected hand | *Immobilize and elevate affected hand | ||
*Tetanus | *Tetanus | ||
Revision as of 18:04, 31 January 2013
Background
- Surgical emergency
- Amputation rates are as high as 30%
- Occurs with grease, paint, and fuel guns; usually injected into non-dominant hand
- Most important factor is type of injected material
- Paint produces large, early inflammatory response w/ high rate of amputation
- Grease causes small inflammatory response w/ lower rate of amputation
Diagnosis
- Benign appearance of small injection site in immediate post-injection period is misleading
- With time digit becomes edematous, pale, and severely tender to palpation
- X-ray
- May show extent of injection of radiopaque substances
Treatment
- Emergent ortho consult
- Early surgical decompression and debridement
- >10hours to OR with increased amp rates
- Immobilize and elevate affected hand
- Tetanus
- Abx
- Analgesia
- Digital blocks are contraindicated
Source
Tintinalli's