2009 Southern Regional Meeting Abstracts

Case Report: PJ Klemawesch, J El-Dahr. Tulane University, New Orleans, LA.
Rationale: Treatment for accidental digital auto-injection of epinephrine is not standardized and described treatments have varying efficacy.
Methods: We describe the case of a 30yo white male physician who accidentally autoinjected an EpiPen into his thumb during a code situation. The pt had severe ischemic symptoms and long-term complications including loss of function and surgical correction were anticipated by evaluating specialists. Warm water immersion and local phentolamine did not relieve symptoms of digital ischemia. The patient was treated with hyperbaric oxygen 2.4 atm, 90 min for 3 treatments.
Results: Symptoms of ischemia, including pallor, pain, and slow capillary refill were alleviated entirely after hyperbaric treatment
Conclusions: Hyperbaric oxygen is an effective alternative treatment for digital ischemia resulting from accidental EpiPen auto-injection. To our knowledge, this is the first reported case of hyperbaric oxygen successfully treating digital ischemia from epinephrine injection