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High-Pressure Hand Injury Clinical Presentation

  • Author: Stewart O Sanford, MD; Chief Editor: Trevor John Mills, MD, MPH  more...
 
Updated: Oct 17, 2015
 

History

The injection typically occurs to the fingertip when the operator is trying to wipe clear a blocked nozzle or to the palm when the operator is attempting to steady the gun with a free hand during the testing or operation of equipment.[10, 11]

The left hand (usually nondominant) is involved in about two thirds of cases.

The most common site of injury is the index finger.

The palm and long finger are the next most frequently injured.

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Physical

The innocuous appearance of the wound may hide the severity of the injury.[12, 8]

With time, edema and intense pain develop and the digit may appear erythematous or cold.

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Causes

Most injuries have resulted from grease guns, paint sprayers, or diesel fuel injectors. The cause of injury in one case report was from a high-pressure paint gun.[13]

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Contributor Information and Disclosures
Author

Stewart O Sanford, MD Clinical Faculty, Department of Emergency Medicine, Albert Einstein Medical Center

Stewart O Sanford, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Eric L Legome, MD Chief, Department of Emergency Medicine, Kings County Hospital Center; Professor Clinical, Department of Emergency Medicine, State University of New York Downstate College of Medicine

Eric L Legome, MD is a member of the following medical societies: Alpha Omega Alpha, Council of Emergency Medicine Residency Directors, American Academy of Emergency Medicine, American College of Emergency Physicians, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Trevor John Mills, MD, MPH Chief of Emergency Medicine, Veterans Affairs Northern California Health Care System; Professor of Emergency Medicine, Department of Emergency Medicine, University of California, Davis, School of Medicine

Trevor John Mills, MD, MPH is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians

Disclosure: Nothing to disclose.

Additional Contributors

Dan Danzl, MD Chair, Professor, Department of Emergency Medicine, University of Louisville Hospital

Dan Danzl, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, Kentucky Medical Association, Society for Academic Emergency Medicine, Wilderness Medical Society

Disclosure: Nothing to disclose.

Acknowledgements

Glen Vaughn, MD Director, Department of Emergency Medicine, Defiance Hospital

Disclosure: Nothing to disclose.

References
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