Annals of Emergency Medicine
Volume 56, Issue 3 , Pages 275-277 , September 2010

Accidental Digital Self-Injection of Epinephrine: Debunking the Myth

  • Adam J. Singer, MD

      Affiliations

    • Corresponding Author InformationAddress for correspondence: Adam Singer, MD, Department of Emergency Medicine, Stony Brook University Hospital, HSC L4-080, Stony Brook, NY 11794; 631-444-7857, fax 631-444-9719

References 

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  3. Madsen PL, Mattson N. Some auto-injection pens are counterintuitive. BMJ. 2009;338:787–788
  4. Fitzcharles-Bowe C, Denkler K, Lalonde D. Finger injection with high dose (1:1000) epinephrine: does it cause finger necrosis and should it be treated?. Hand. 2007;2:5–11
  5. McGovern S. Treatment of accidental digital injection of adrenaline from an auto-injector device. J Accid Emerg Med. 1997;14:379–380
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  10. Denkler KA. Comprehensive review of epinephrine in the finger: to do or not to do. Plast Reconstr Surg. 2001;108:114–124
  11. Krunic AL, Wang LC, Soltani K, et al. Digital anesthesia with epinephrine: an old myth revisited. J Am Acad Dermatol. 2004;51:755–759
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  14. Wilhelmi BJ, Blackwell SJ, Miller JH, et al. Do not use epinephrine in digital blocks: myth or truth?. Plast Recontr Surg. 2001;107:393–397
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  19. Muck AE, Bebarta VS, Borys DJ, et al. Six years of epinephrine digital injections: absence of significant local or systemic effects. Ann Emerg Med. 2010;56:270–274
  20. Kaspersen J, Vedsted P. Accidental injection of adrenaline in a finger with EpiPen. Ugeskr Laeger. 1998;45:6531–6532
  21. Stier PA, Bogner MP, Webster K, et al. Use of subcutaneous terbutaline to reverse peripheral ischemia. Am J Emerg Med. 1999;1:91–94
  22. Hardy SJ, Agostini DE. Accidental epinephrine auto-injector-induced digital ischemia reversed by phentolamine digital block. J Am Osteopath Assoc. 1995;6:377–378
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  24. Burkhart KK. The reversal of the ischemic effects of epinephrine on a finger with local injections of phentolamine. J Emerg Med. 1992;10:496
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 Supervising editor: Richard C. Dart, MD, PhD

 Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article that might create any potential conflict of interest. The author has stated that no such relationships exist. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement.

 Publication date: Available online March 26, 2010.

 Reprints not available from the author.

PII: S0196-0644(10)00225-8

doi: 10.1016/j.annemergmed.2010.03.008

Annals of Emergency Medicine
Volume 56, Issue 3 , Pages 275-277 , September 2010

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