High-pressure injection injury: Difference between revisions
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**May show extent of injection of radiopaque substances | **May show extent of injection of radiopaque substances | ||
==Treatment== | '''Bold text'''==Treatment== | ||
*Emergent ortho consult | *Splint and Elevate | ||
*Emergent ortho/hand surgeon consult | |||
**Admission | |||
*Early surgical decompression and debridement | *Early surgical decompression and debridement | ||
**>10hours to OR with increased amp rates | **>10hours to OR with increased amp rates | ||
*Tetanus | *Tetanus | ||
*Abx | *Abx | ||
Revision as of 17:32, 25 January 2015
Background
- Surgical emergency
- Amputation rates are as high as 30%
- Occurs with grease, paint, and fuel guns; usually injected into non-dominant hand
- Most important factor is type of injected material
- Paint produces large, early inflammatory response w/ high rate of amputation
- Grease causes small inflammatory response w/ lower rate of amputation
Diagnosis
- Benign appearance of small injection site in immediate post-injection period is misleading
- With time digit becomes edematous, pale, and severely tender to palpation
- X-ray
- May show extent of injection of radiopaque substances
Bold text==Treatment==
- Splint and Elevate
- Emergent ortho/hand surgeon consult
- Admission
- Early surgical decompression and debridement
- >10hours to OR with increased amp rates
- Tetanus
- Abx
- Analgesia
- Digital blocks are contraindicated
Source
Tintinalli's