A New Approach to Management of Intravenous Infiltration in Pediatric Patients

Amjad, Ibrahim; Murphy, Travis; Nylander-Housholder, Linda; Ranft, Amanda

doi:10.1097/nan.0b013e31821da1b3

Cited by 51 publications

(49 citation statements)

References 22 publications

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“…7,8 The degree of pain, extent of swelling, presence of blanching, and extent of circulatory impairment are incorporated into most of these classification systems (Table 1). Revised scales for pediatric and neonatal infiltrations have also been created to account for the smaller surface area and distinctive presentations of injury.…”

Section: Definitions Classifications Of Injury and Risk Factors Formentioning

confidence: 99%

“…Revised scales for pediatric and neonatal infiltrations have also been created to account for the smaller surface area and distinctive presentations of injury. 8 The etiology of extravasation and infiltration injuries can be separated into two different categories: mechanical and pharmacologic. 4 Mechanical contributions to extravasation injuries largely involve cannulation technique or a patient's physiologic predisposition to infiltration injury.…”

Section: Definitions Classifications Of Injury and Risk Factors Formentioning

confidence: 99%

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Management of Extravasation Injuries: A Focused Evaluation of Noncytotoxic Medications

et al. 2014

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Extravasations are common manifestations of iatrogenic injury that occur in patients requiring intravenous delivery of known vesicants. These injuries can contribute substantially to patient morbidity, cost of therapy, and length of stay. Many different mechanisms are behind the tissue damage during extravasation injuries. In general, extravasations consist of four different subtypes of tissue injury: vasoconstriction, osmotic, pH related, and cytotoxic. Recognition of high-risk patients, appropriate cannulation technique, and monitoring of higher risk materials remain the standard of care for the prevention of extravasation injury. Prompt interdisciplinary action is often necessary for the treatment of extravasation injuries. Knowledge of the mechanism of extravasation-induced tissue injury, agents for reversal, and appropriate nonpharmacologic treatment methods is essential. The best therapeutic agent for treatment of vasopressor extravasation is intradermal phentolamine. Topical vasodilators and intradermal terbutaline may provide relief. Intradermal hyaluronidase has been effective for hyperosmotic extravasations, although its use largely depends on the risk of tissue injury and the severity of extravasation. Among the hyperosmotic agents, calcium extravasation is distinctive because it may present as an acute tissue injury or may possess delayed clinical manifestations. Extravasation of acidic or basic materials can produce significant tissue damage. Phenytoin is the prototypical basic drug that causes a clinical manifestation known as purple glove syndrome (PGS). This syndrome is largely managed through preventive and conservative treatment measures. Promethazine is acidic and can cause a devastating extravasation, particularly if administered inadvertently through the arteriolar route. Systemic heparin therapy remains the accepted treatment option for intraarteriolar administration of promethazine. Overall, the evidence for managing extravasations due to noncytotoxic medications is nonexistent or limited to case reports. More research is needed to improve knowledge of patient risk, prompt recognition of the extravasation, and time course for tissue injury, and to develop prevention and treatment strategies for extravasation injuries.

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Section: Definitions Classifications Of Injury and Risk Factors Formentioning

confidence: 99%

Section: Definitions Classifications Of Injury and Risk Factors Formentioning

confidence: 99%

Management of Extravasation Injuries: A Focused Evaluation of Noncytotoxic Medications

et al. 2014

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“…Although the topical use of nitroglycerin is recommended because of its vasodilating action, which leads to a decrease in tissue ischemia, this medicine may cause hypotension; it should be used with caution in children and it requires continuous hemodynamic monitoring during use (10,20) .…”

Section: Hospitalization Can Cause Lesions On the Skin Of Newborn Chimentioning

confidence: 99%

“…In order to prevent further tissue damage, interruption of the infusion is recommended at the slightest sign of leakage, as well as elevation of the affected area in order to promote venous return and the reabsorption of fluid. The subcutaneous administration of hyaluronidase, an enzyme which temporarily reduces the viscosity of the intercellular cement and promotes the absorption of extravasated fluids, is also recommended because it decreases tissue damage by toxic substances (10,20) .…”

Section: Hospitalization Can Cause Lesions On the Skin Of Newborn Chimentioning

confidence: 99%

Treatment of skin lesions in newborn children: meeting the needs of nursing staff

Santos

Costa

2014

Rev. esc. enferm. USP

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Treatment of skin lesions in newborn children: meeting the needs of nursing staff RESUMEN Objetivo: Conocer, junto al equipo de enfermería, los cuidados necesarios para el tratamiento de lesiones de piel en recién nacidos internados en una Unidad Neonatal. Método: Investigación cualitativa del tipo Convergente Asistencial. Los datos fueron obtenidos por medio de entrevistas semiestructuradas, realizadas en los meses de noviembre a deciembre de 2012, en la Unidad Neonatal de un hospital del Sur de Brasil. Participaron de la investigación cuatro auxiliares de enfermería, seis téc-nicos de enfermería y cuatro enfermeras. Resultados: Se originaron tres categorías: dudas acerca de lo que se puede utilizar en el recién nacido; la estancia hospitalaria puede causar lesiones en la piel del recién nacido; y el conocimiento del cuidado promueve autonomía profesional. Conclusión: Se hace urgente la necesidad de conocimiento del equipo acerca del tratamiento de las lesiones, a fin de proporcionar una atención más segura al recién nacido y favorecer la autonomía del profesional enfermero en la puesta en marcha del cuidado. DESCRIPTORES ABSTRACTObjective: to understand, together with nursing staff, the care needed to treat skin lesions in newborn children hospitalized in a neonatal unit. Method: qualitative research, of the convergent care type. The data was collected through semi-structured interviews, which were conducted from November to December 2012, in the neonatal unit of a hospital in southern Brazil. The participants were four auxiliary nurses, six nursing technicians and four nurses. Results: the following three categories were designated: questions about what can be used in relation to newborn children; hospitalization can cause lesions on the skin of newborn children; and knowledge about care promotes professional autonomy. Conclusion: there is an urgent need for staff to know more about the treatment of skin lesions, which would provide safer care for newborn children and would also support the autonomy of professional nurses in providing that care.

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“…İnfiltrasyonlar çoğunlukla bölgede kızarıklık, şişlik ve büller oluşturur. Herhangi bir doku kaybı gelişmez (1,3,4).…”

Section: Introductionunclassified

Turkish Validity Reliability of the Pediatric Peripheral Intravenous Infiltration Scale and Its Adaptation to Newborns

Temizsoy¹,

Eriş²,

Karakoç³

et al. 2017

jpr

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A New Approach to Management of Intravenous Infiltration in Pediatric Patients

Cited by 51 publications

References 22 publications

Management of Extravasation Injuries: A Focused Evaluation of Noncytotoxic Medications

Management of Extravasation Injuries: A Focused Evaluation of Noncytotoxic Medications

Treatment of skin lesions in newborn children: meeting the needs of nursing staff

Turkish Validity Reliability of the Pediatric Peripheral Intravenous Infiltration Scale and Its Adaptation to Newborns

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