Recognising high-pressure injection injuries to the hand: a practice review with guidance for emergency physicians

High-pressure pneumatic guns, commonly used in industrial settings for tasks such as painting and cleaning, pose a significant risk of hand injuries since they can generate pressures up to 12 000 pounds per square inch. Despite their rarity, these injuries can have severe consequences, including permanent functional impairment and an elevated risk of amputation. Often underestimated in the community setting, high-pressure injection injuries (HPII) frequently evade early recognition, leading to detrimental outcomes. Using two illustrative cases, this practice review outlines the challenges in recognising and managing these injuries, highlighting the need for increased awareness among emergency healthcare practitioners. Early recognition is challenging and crucial, as it facilitates timely referral to hand specialists for comprehensive management, improving patient outcomes. Standardising diagnostic guidelines is also considered a potentially impactful topic of future work. By addressing these priorities, we can enhance patient care and mitigate the burden of these injuries on individuals and communities.