Most Accidental Injections of Epinephrine (EpiPen) Into Finger Do Not Require Treatment

According to a study of 127 injections, ischemia in the EpiPen-injected finger is rare, and when it does occur, it can be managed with vasodilators.


Accidental Injection of Epinephrine Into Finger (click to enlarge the image).

No patient had any significant local or systemic side effects, and symptoms resolved completely in all cases. 3.1% of patients were reported as having an ischemic finger and all were treated with vasodilator therapy and sent home.

In the absence of signs of poor perfusion (pain, pallor, paresthesias, prolonged capillary refill, and cool temperature), patients with an accidental autoinjector stick require no treatment and can be discharged home. If digital ischemia is present, dilute phentolamine in lidocaine should be injected subcutaneously into the site until the area turns pink.

References:
Medscape, 2010, http://www.medscape.com/viewarticle/720014
Annals of Emergency Medicine, March 29, 2010.
What are the ‘ideal’ features of an adrenaline (epinephrine) auto-injector in the treatment of anaphylaxis? http://goo.gl/lxCh
Figure: Design overview of currently available auto-injectors for emergency self-administration of adrenaline in the treatment of anaphylaxis.
Image source: Don Park and Mat Honan.

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