Accidental digital injection of adrenaline from an auto-injector device

A 29 year old female colleague presented to the Emergency Department, of Hamad General Hospital, with an accidental injection of adrenaline into her right thumb from an auto-injector device. She received the injury whilst she was teaching her mother, an acute allergy sufferer, how to use the auto-injector. On arrival at the emergency department, her right thumb was pale, edematous and cold, so she was immediately given a local infiltration of 0.5% phentolamine mesylate [injected at the puncture site], a digital block with lidocine 1% and the thumb was wrapped with a trans-dermal nitroglycerin patch. One hour later the right thumb became pinkish, warm and the edema subsided. The patient was discharged home with outpatient follow-up