Digital ischaemia in the digital age

After the accidental injection of epinephrine into a digit, various techniques to try and reverse the ensuing ischaemia were unsuccessful. To identify a further treatment strategy and as members of the admitting team were unfamiliar with digital injection of epinephrine a Google search was performed. Previous cases were described and separate sources indicated appropriate management protocols utilising phentolamine. After administration, an almost immediate reversal of ischaemic symptoms occurred. This highlights the role of the internet as an adjunct in managing unfamiliar situations and practising evidence based medicine.