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High-Pressure Water Injection Injury Management

As disaster clean-up efforts are underway, pressure injection injuries from use of pressure washers may increase.

The seriousness of high pressure injection injuries is generally underestimated. The wounds often appear benign, but these injuries can result in serious infection, disability and amputation if not treated appropriately. The potential for serious injury should be considered with any device that produces greater than 100 pounds per square inch (PSI) of pressure.

Immediate recognition of the injury is crucial to successful management.


  • Assess the wound (often appears very small and innocuous)
  • Assess neurovascular status
  • Assess tendon function


  • X-Ray the injured area to check for presence of subcutaneous air or foreign body
  • Administer tetanus vaccination or ensure that tetanus prophylaxis is up to date
  • Administer antibiotics
  • Refer urgently to a surgeon for probable wound debridement
  • Avoid use of digital blocks

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