Recent Feedback
hi im an er nurse, i had a 85 yr old pt with hyperkalemia. so we did our insulin / d50w trick. so the pt came with a ine with ems . the line was flushing ok and i gave the insulin and then i started to push the amp of d50. as i was pushing(slowly..) the line infiltrated. it seemed to me like 10 or so ccs on the antecubital. so i stopped and pulled the line. i put a cool compress as the pt said it was burning and then followed with 2 warms and watched it for the rest of the shift. i had an er dr look at it. he said it was ok... but my concern of course is necrosis. how long until we would know theres going to be necrosis? and how likely do you think it is? the swelling did reduce and it softened but didnt completely go away...
Hellothere does not seem to be any reason for necrosis here.Everything was done correctly.If it looks like swelling is reduced and it is improving over 48 hours...no concern.Let me know if you have further questions, details or need clarification, just use reply.......
Experience: Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
ok so what would make you more likely say oh theres going to be necrosis? what if it was a arger amt of d50w? lie if ive underestimated and its more that the 10 - 20 ccs b/c its deeper into the arm? i felt so bad - im not using ems lines anymore they always suck. then i had to pop a new line and push this amp thru the other line right away. im also concerned that the nurses after me dont give a crap even though i begged the nurse i left to place another warm compress and keep an eye on it...
No unlikely there is going to be any necrosis.even with a larger amount of D50.
oh. how come they make a whole big deal about it? i thought they say if it infiltrates it does that..? the necrosis i mean....
It is not oftenYou have to be careful in case you have a rare incidence.It is making a big deal preventively
ok fair enough. im off but im still worried about this ladys arm. thx for your help. i hope itll just be ok.
I would say it will.