August 2021: What You Get is More than You See

​“I want you to look at this guy's finger," a resident said. “What do you think?"Looking at the tiny bubble of blood in the teeny puncture wound, my response was, "Depends. What happened?"There must be way more to this story for this guy to be here. Was he brought in against his will by the police or an insistent wife? Was something lodged in there? A mishap with a BB gun? Perhaps a work injury, and he needs paperwork to be able to get his paycheck?No matter which, this small puncture wound hardly seemed big enough to garner such attention. There was only one thing that looked like this and could stop the normal flow of patients in and out of the fast track. Was this it?And the x-ray?​Yes! There it was, just as I suspected! Air tracking up the finger and halfway up the metacarpals. This guy had a power injection injury!Luckily for him, it was only water and air, which meant that he might not need surgery and had a much better shot of keeping his finger. Other substances are much more toxic and can lead to amputation in more than a few cases. Even water and air create a risk for compartment syndrome.Our patient was given antibiotics, tetanus immunization, and transferred for evaluation by a hand specialist.Tip to Remember: Remember to ask about the mechanism of injury because sometimes what you get is way more than you see.Reference:Hancock E, et al. A Hand Wound Caused by a Pressure Washer," J Urgent Care Med; https://bit.ly/3qJA9y...
Source: Lions and Tigers and Bears - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs