Digital EpiPen injection - Revision history

Mholtz at 10:53, 12 December 2017

2017-12-12T10:53:59Z

2017-12-12T07:57:10Z

Text replacement - "==Treatment==" to "==Management=="

← Older revision		Revision as of 07:57, 12 December 2017
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	*Typically a clinical diagnosis (no testing required)		*Typically a clinical diagnosis (no testing required)

	==~~Treatment~~==		==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>

2017-10-29T03:30:52Z

Differential Diagnosis

← Older revision		Revision as of 03:30, 29 October 2017
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	==Differential Diagnosis==		==Differential Diagnosis==
			*Injection of other medication
	*Retained [[foreign body]]		*Retained [[foreign body]]
	*[[Allergic reaction]]		*[[Allergic reaction]]

2017-10-29T03:30:16Z

Differential Diagnosis

2017-10-29T03:29:16Z

Treatment

← Older revision		Revision as of 03:29, 29 October 2017
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	*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>
	*If continued ischemia symptoms after 2 hrs, inject [[phentolamine]] into the ischemic area (see procedure below)		**If continued ischemia symptoms after 2 hrs, inject [[phentolamine]] into the ischemic area (see procedure below)

	===Digital [[Phentolamine]] Injection Procedure<ref>http://emj.bmj.com/content/21/3/387/</ref>===		===Digital [[Phentolamine]] Injection Procedure<ref>http://emj.bmj.com/content/21/3/387/</ref>===

2017-10-29T03:29:03Z

Treatment

← Older revision		Revision as of 03:29, 29 October 2017
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	*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>
	*If continued ischemia symptoms after 2 hrs		*If continued ischemia symptoms after 2 hrs, inject [[phentolamine]] into the ischemic area (see procedure below)
	**give [[phentolamine~~]] mesylate 1.5mg in 1 mL of [[lidocaine~~]] into the ischemic area

	===Injection Procedure<ref>http://emj.bmj.com/content/21/3/387/</ref>===		===Digital [[Phentolamine]] Injection Procedure<ref>http://emj.bmj.com/content/21/3/387/</ref>===
	====Equipment Needed====		====Equipment Needed====
	*10cc syringe		*10cc syringe
	*~~phentolamine~~		*Phentolamine mesylate
	*1-2% lidocaine (WITHOUT epinephrine)		*1-2% lidocaine (WITHOUT epinephrine)
	*25g needle		*25g needle

	====Technique====		====Technique====
	*Dilute 1.5mg of phentolamine mesilate in ~~1ml~~ of 2% lidocaine.		*Dilute 1.5mg of [[phentolamine]] mesilate in 1mL of 2% lidocaine.
	*Inject subQ into the site and stop when tissue turns pink again.		*Inject subQ into the site and stop when tissue turns pink again.
	*Observe and repeat as necessary.		*Observe and repeat as necessary.

2017-10-29T03:27:15Z

Injection Procedurehttp://emj.bmj.com/content/21/3/387/

← Older revision		Revision as of 03:27, 29 October 2017
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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''~~

	====Equipment Needed====		====Equipment Needed====
	*10cc syringe		*10cc syringe

2017-10-29T03:27:02Z

Injection Procedurehttp://emj.bmj.com/content/21/3/387/

← Older revision		Revision as of 03:27, 29 October 2017
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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''

	~~====Indications====~~
	~~For use when epinephrine is accidentally or inappropriately injected~~

	~~====Contraindications====~~
	~~Drug class allergy or non-ischemia.~~

	====Equipment Needed====		====Equipment Needed====

2017-10-29T03:26:28Z

Equipment Needed

← Older revision		Revision as of 03:26, 29 October 2017
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	====Equipment Needed====		====Equipment Needed====
	10cc syringe, phentolamine, 1-2% lidocaine, 25g needle.		*10cc syringe
			*phentolamine
			*1-2% lidocaine (WITHOUT epinephrine)
			*25g needle

	====Technique====		====Technique====

2017-10-29T03:25:48Z

Technique

← Older revision		Revision as of 03:25, 29 October 2017
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	====Technique====		====Technique====
	Dilute 1.5mg of phentolamine mesilate in 1ml of 2% lidocaine.		*Dilute 1.5mg of phentolamine mesilate in 1ml of 2% lidocaine.
	Inject subQ into the site and stop when tissue turns pink again.		*Inject subQ into the site and stop when tissue turns pink again.
	Observe and repeat as necessary.		*Observe and repeat as necessary.

	==Disposition==		==Disposition==