• Login
    View Item 
    •   Home
    • The Christie Research Publications Repository
    • All Christie Publications
    • View Item
    •   Home
    • The Christie Research Publications Repository
    • All Christie Publications
    • View Item
    JavaScript is disabled for your browser. Some features of this site may not work without it.

    Browse

    All of ChristieCommunitiesTitleAuthorsIssue DateSubmit DateSubjectsThis CollectionTitleAuthorsIssue DateSubmit DateSubjectsProfilesView

    My Account

    LoginRegister

    Local Links

    The Christie WebsiteChristie Library and Knowledge Service

    Statistics

    Display statistics

    Adrenaline Auto-injector injuries to digits; a systematic review and recommendations for emergency management

    • CSV
    • RefMan
    • EndNote
    • BibTex
    • RefWorks
    Authors
    Walsh, Karl
    Baker, BG
    Iyer, S
    Affiliation
    Department of Plastic Surgery, The Christie NHS Foundation Trust, Wilmslow Rd, Manchester M20 4BX, UK.
    Issue Date
    2020
    
    Metadata
    Show full item record
    Abstract
    AIMS: Accidental injury to digits with Adrenaline Auto-injectors (AAIs) is becoming increasingly common. Digital AAI injury causes painful ischaemia that can lead to necrosis and patient anxiety. There is a lack of understanding amongst surgeons regarding how to manage these injuries. We aimed to determine an optimal treatment algorithm for their management. METHODS: We conducted a systematic review using the search engines MEDLINE, PubMed, EMBASE, CINAHL, BNI, AMED, Google Scholar. Search items included ("epinephrine OR adrenaline") AND ("Digit" OR "Finger" OR "Thumb") AND ("Injury" OR "Accidental"). RESULTS: A total of 49 articles were identified describing 111 cases. In 58 cases; 52% of cases were managed with phentolamine, 24% were managed with nitroglycerine and 7% were treated with warm soaks. The remaining 17% of cases were managed with a variety of alternative treatments. Mean recovery time following treatment with phentolamine infiltration was 33 min, whilst symptoms persisted for several hours in some cases with observation/warm soaks and nitroglycerine. Phentolamine was more effective when injected into the AAI puncture site (mean resolution time: 17 min) in comparison to injection as a digital block (74 min). CONCLUSION: Phentolamine is the most effective method of reversing symptoms and treating ischaemic digits when compared to alternative therapies. Symptoms resolved much quicker when phentolamine was infiltrated into the site of injury compared to being infiltrated as a digital block. We propose a treatment algorithm for management of these injuries. Hand surgeons should be aware of AAI injuries and be able to advise on their management.
    Citation
    Walsh K, Baker BG, Iyer S. Adrenaline Auto-injector injuries to digits; a systematic review and recommendations for emergency management. Surgeon. 2020.
    Journal
    Surgeon
    URI
    http://hdl.handle.net/10541/622799
    DOI
    10.1016/j.surge.2020.01.005
    PubMed ID
    32044290
    Additional Links
    https://dx.doi.org/10.1016/j.surge.2020.01.005
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.surge.2020.01.005
    Scopus Count
    Collections
    All Christie Publications

    entitlement

    Related articles

    • Accidental adrenaline auto-injector-induced digital ischaemia: a proposed treatment algorithm.
    • Authors: Rajiah E, McKean AR, Bain C
    • Issue date: 2021 Apr 28
    • Accidental epinephrine auto-injector-induced digital ischemia reversed by phentolamine digital block.
    • Authors: Hardy SJ, Agostini DE
    • Issue date: 1995 Jun
    • Correct treatment for accidental epinephrine auto-injector-induced digital ischemia.
    • Authors: Brenner GM
    • Issue date: 1995 Sep
    • Treatment of accidental digital injection of adrenaline from an auto-injector device.
    • Authors: McGovern SJ
    • Issue date: 1997 Nov
    • The EpiPen and the ischaemic finger.
    • Authors: Singh T, Randhawa S, Khanna R
    • Issue date: 2007 Aug
    DSpace software (copyright © 2002 - 2025)  DuraSpace
    Quick Guide | Contact Us
    Open Repository is a service operated by 
    Atmire NV
     

    Export search results

    The export option will allow you to export the current search results of the entered query to a file. Different formats are available for download. To export the items, click on the button corresponding with the preferred download format.

    By default, clicking on the export buttons will result in a download of the allowed maximum amount of items.

    To select a subset of the search results, click "Selective Export" button and make a selection of the items you want to export. The amount of items that can be exported at once is similarly restricted as the full export.

    After making a selection, click one of the export format buttons. The amount of items that will be exported is indicated in the bubble next to export format.