High-pressure injection injuries, though rare, carry high rates of morbidity and amputation despite a potentially benign initial presentation. Emergency physicians must have a high index of suspicion and be ready to act quickly when evaluating this presenting complaint. In this case report, a patient presented to the emergency department with a chief complaint of finger pain after a pressure washer came into contact with his right index finger. He subsequently developed pain, numbness and a white discoloration to his finger surrounding a small puncture wound. Key interventions in his care included rapid assessment, beginning broad spectrum antibiotics, and quickly consulting the hand surgery team.Despite the potential for significant morbidity with this injury, expedited evaluation and treatment in this case allowed for adequate retention of function in the affected digit, with only mildly decreased pincer function. In summary, the early mobilization of resources for patients with high-pressure injection injuries, especially early surgical consultation, is paramount to achieving positive outcomes.TopicsFinger injury, hand injury, high-pressure injection injury.