Use of glyceryl trinitrate patches in the treatment of accidental digital injection of epinephrine from an autoinjector.

摘要

The use of epinephrine autoinjectors for self-administration at times of severe allergic reaction is on the rise both in children and adults [1]. Increased incidence of patients visiting emergency departments with accidental epinephrine injection (Epipen) injuries is also observed worldwide [2,3]- The suggested incidence in the United Kingdom is about 1/50 000 Epipen Units [1]. The use of epinephrine autoinjectors in children below 10 years of age has increased by 300% over the last 5 years with a crude rate of Epipen provision of 1 per 544 Australian children below 10 years of age. Digital injection of epinephrine produces spasm of the end arteries and hence has a potential for digital necrosis. In the literature there are various documented forms of treatments [3-6]. We report seven cases that have been effectively treated by simple application of glyceryl trinitrate (GTN) patches in the emergency departments at The Royal Berkshire Hospital, Reading and at Raigmore Hospital, Inverness.