Sunday, June 6, 2010

High Pressure Injection Injuries

A 19 year old male came in for finger pain. There was no obvious signs of trauma, and he denied any trauma. There was just a little swelling to the finger....

One thing to look out for in suspicious cases like this is high pressure injection injuries from things like paint. It is a common injury from pain sprayers. But it is hard sometimes to get a patient to admit to the injury if they were doing something illegal....like graffiti. This is a big mistake, because early on the physical exam of the finger is almost totally normal. but within 24 hours the finger can become necrotic and need to be amputated. Early debridement is key.



The white cloudy stuff is the paint/oil


-ER Doc

10 comments:

April said...

wow! who would have thought? Now I have another form of trauma to be paranoid about.

tracy said...

So, is that kind of like a compart(mental) injury? Like "BJ" had on "MASH"? LOL, my medical "education". Or am i totally waaaay off base on everything concerned?
tracy, trying to behave ;)

Hee "mental" Cannot escape if i try!

Anonymous said...

So where can I get a "pain sprayer?" I know a lot of people who could use a good spraying!

Hopalong Ginsberg

tracy said...

i have no right to ask favors, however, if any of you three Doctor's have a minute, could you pop over to my friend Dr. Sara's blog at http://sarainisrael.blogspot.com/ and offer an oppinion? It's a great blog, anyhow! :)
Thanks so much!

Ha, ha verification "reminise"

Hee, Anon!

Pissed Off Patient said...

I don't quite follow this entry, maybe I'm too tired. So the spray paint leached into his finger?????

I did chuckle at your typo of pain for paint. Not the first time I've seen it either.

I used to have a customer in China who sent me emails that went:

"Do me a fever and send me some pain, a full container of pain please."

I never stopped cracking up at those emails.

M

Anonymous said...

Not regular spray paint. High pressure paint sprayers, paint guns, etc...

Anonymous said...

I saw one of these as a med student. The guy was spraying latex paint and accidentally injected his entire hand with latex paint. He waited 6 hours before coming in - super interesting hand surgery - the latex was basically solid and surrounding every structure in his hand. He ended up doing great.

arzt4empfaenger said...

Wow! Also scary, I could imagine that a lot of guys would wait to see the doc because it was just a "small accident" and seemingly harmless. Also, it definitely made me cautious in case I'll be brandishing some high pressure spraying later when we're working up the flat we're going to move into.

Anonymous said...

What's the treatment?

Guzzo said...

While I'm all against graffiti, I've never known a tagger to use a high pressure paint sprayer. It seems like it would be too difficult to find a power source, and too bulky to carry around and change paint colors. BUT.. crazier things have happened.