Peripheral intravenous (PIV) infiltrates and extravasations
We treat a large number of PIV infiltrates and extravasations. The most common sites are the dorsum of the hand, dorsum, of the foot, and the wrist or forearm. These are sites where subcutaneous tissue is very thin, putting the skin and superficial tissue layers at risk for damage/ injury. Neonates are especially at risk due to poor venous integrity, greater risk for capillary leaking, and decreased peripheral circulation. They are also at risk due to their inability to state that they are in pain.
Infiltration - IV fluid leaks into surrounding tissues of the vein.
Extravasation - can lead to complications, including skin and soft tissue injury. s/s: edema subcutaneous inflammation and pain, discomfort, and in severe cases compartment syndrome
Vesicant - include TPN, Dextrose (for concentrations 10% or greater)
Extravasation - can lead to complications, including skin and soft tissue injury. s/s: edema subcutaneous inflammation and pain, discomfort, and in severe cases compartment syndrome
Vesicant - include TPN, Dextrose (for concentrations 10% or greater)
Treatment:
- Generally, ice and elevate is the primary treatment. Ice the site for 15-20 min. QID for the first 24 hours. Keep the extremity elevated as much as possible.
- Hyaluronidase (Wydase) - 0.1-0.2ml injected five times into the subcutaneous tissue surrounding the extravasation