BCEN CEN Practice Question

High-pressure injection injuries are surgical emergencies. The initial presentation of a small puncture wound is misleading and belies the extensive underlying tissue damage caused by the force and chemical nature of the injected substance. The priority is to prepare for emergent surgical decompression and debridement to remove the foreign material and reduce pressure. Therefore, the most appropriate initial actions include immobilizing the extremity, administering tetanus prophylaxis and broad-spectrum antibiotics, and ensuring an urgent surgical consultation. Applying a pressure dressing or performing a digital nerve block is contraindicated as it can further increase compartment pressure. Irrigating the wound in the emergency department is not recommended as it may not be effective for deep contamination and could potentially spread the toxic substance further into the tissue planes.