UMEM Educational Pearls

Category: Toxicology

Title: Epinephrine Digital Injections

Keywords: Epinephrine, epi-pen, digital block, finger, ischemia (PubMed Search)

Posted: 9/2/2010 by Ellen Lemkin, MD, PharmD
Click here to contact Ellen Lemkin, MD, PharmD

A recent study examined the effects of accidental digital epinephrine injection from auto-injectors. 127 cases with complete follow-up had the following effects:

  • no effects were reported in 10%
  • minor effects in 77%
  • moderate effects in 13%
  • major effects in 1 case

Pharmacologic vasodilators were used in 23%. Four patients had possible digital ischemia. All patients had complete resolution of symptoms, most within 2 hours. No patient was admitted, received hand surgery consultation, or had surgical care. 

Although this speaks for the safety of digital anesthesia using epinephrine, it underscores the importance of providing education to patients who are prescribed epinephrine auto-injectors.




Muck AE, Bebarta VS, Borys DJ, MOrgan DL. Six Years of Epinephrine Digital Injections: Absence of Significanct Local or Systemic Effects. Ann Em Med Sept 2010;56(3);270-4.

Singer AJ. Accidental Digital Self-Injection of Epinephrine: Debunking the Myth. Sept 2010;56(3):275-7.