Digital EpiPen injection: Difference between revisions
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*If continued ischemia symptoms after 2 hrs | *If continued ischemia symptoms after 2 hrs | ||
**give [[phentolamine]] mesylate 1.5mg in 1 mL of [[lidocaine]] into the ischemic area | **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>=== | |||
''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, 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== | ==Disposition== | ||
Revision as of 03:25, 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, 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/