Ver el código de «Digital EpiPen injection»

==Background==
*Accidental digital self-injection of epinephrine from an EpiPen.

==Clinical Features==
*Puncture wound with delayed capillary refill (vasoconstriction)

==Differential Diagnosis==
*Injection of other medication
*Retained [[foreign body]]
*[[Allergic reaction]]
*[[Cellulitis]]

==Evaluation==
*Typically a clinical diagnosis (no testing required)

==Treatment==
*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.
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**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>===
====Equipment Needed====
*10cc syringe
*Phentolamine mesylate
*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==
*[[Epinephrine]]

==References==
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[[Category:Toxicology]]