title: Accidental injection of epinephrine from an autoinjector: invasive treatment not always required.
abstract: BACKGROUND
  Individual case reports of accidental injection with epinephrine appear in the literature and seem to represent the worst case scenarios. We present a case series of 28 exposures to epinephrine via autoinjector.
  
  
  METHODS
  All accidental parenteral injections of epinephrine by autoinjector reported to two regional poison information centers over a 2-year period were included.
  
  
  RESULTS
  Injection sites included digits (23 cases), palm (4 cases), and thigh (1 case). Symptoms included swelling, pallor, pain, and erythema. Four patients reported no effect, and 9 required no treatment. Ten patients obtained relief with warm soaks, 1 patient had massage only, and 2 patients were lost to follow-up. Fourteen were examined in the emergency department, and 14 were treated at home.
  
  
  CONCLUSIONS
  Although some injection injuries must be treated in an emergency facility, many can be treated at home. Immediate referral to a health care facility is not needed in all cases and at times is unwarranted.
authors.affiliation: Pittsburgh Poison Center, Children's Hospital of Pittsburgh, PA 15213, USA.
authors.forename: Rita
authors.initials: R
authors.lastname: Mrvos
authors.forename: Bruce D
authors.initials: BD
authors.lastname: Anderson
authors.forename: Edward P
authors.initials: EP
authors.lastname: Krenzelok
mesh_terms: D000059:Accidents; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004837:Epinephrine / Q000008:administration & dosage* / Q000506:poisoning*; D005260:Female; D006801:Humans; D007267:Injections / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D011041:Poisoning / Q000628:therapy*; D011247:Pregnancy; D012189:Retrospective Studies; D013566:Sympathomimetics / Q000008:administration & dosage* / Q000506:poisoning*
chemical_list: D013566:Sympathomimetics; D004837:Epinephrine