Re: CT Contrast Extravasation

[Nancy Costa]

Title: Message

Thank you Nancy - and so eloquently stated!  In addition - the hypertonicity of most contrast media accelerates the inflammatory response.  Have you heard Darnell's story about the young girl who developed compartment syndrome from (non-ionic)contrast extravasation?  ----- Original Message ----- From: Nancy Moureau To: 'Nancy Costa' ; [EMAIL PROTECTED] ; [EMAIL PROTECTED] ; [EMAIL PROTECTED] ; [EMAIL PROTECTED] Sent: Wednesday, November 23, 2005 10:54 AM Subject: RE: CT Contrast Extravasation I would think that elevation would reduce extracellular/interstitial pooling, improve circulatory return and through that mechanism reduce swelling that could injure nerves and other structure due to pressure. In other words get the fluids back into the main circulation quickly.     Nancy Moureau, BSN, CRNI PICC Excellence, Inc. 888-714-1951 www.piccexcellence.com [EMAIL PROTECTED]   -----Original Message----- From: Nancy Costa [mailto:[EMAIL PROTECTED] Sent: Wednesday, November 23, 2005 6:15 AM To: [EMAIL PROTECTED]; [EMAIL PROTECTED]; [EMAIL PROTECTED]; [EMAIL PROTECTED]; [EMAIL PROTECTED] Subject: Re: CT Contrast Extravasation Elevation may help with swelling, hasn't been shown to hurt.  Most sources now say elevate or position according to patient comfort... ----- Original Message ----- From: [EMAIL PROTECTED] To: [EMAIL PROTECTED] ; [EMAIL PROTECTED] ; [EMAIL PROTECTED] ; [EMAIL PROTECTED] ; [EMAIL PROTECTED] Sent: Tuesday, November 22, 2005 9:48 PM Subject: Re: CT Contrast Extravasation What exactly does elevating the extremity accomplish? LA  -----Original Message----- From: Nancy Costa <[EMAIL PROTECTED]> To: Kimberly Sutters <[EMAIL PROTECTED]>; [EMAIL PROTECTED]; [EMAIL PROTECTED]; Lynn Hadaway <[EMAIL PROTECTED]> Cc: Kimberly Sutters <[EMAIL PROTECTED]> Sent: Mon, 21 Nov 2005 05:27:34 -0500 Subject: Re: CT Contrast Extravasation Recomendations for treatment of contrast media extravasations from the American College of Radiology are:   Elevate affected extremity Apply ice packs at 15-60 minute intervals Call physician if volume > 5ml Consult plastic surgeon if volume:          > 30ml ionic contrast          > 100ml non-ionic contrast Monitor patient for:          Blistering          Ulceration          Altered tissue perfusion, sensation or temperature          Increased or persistent pain American College of Radiology Committee on Drugs and Contrast Media.  Manual on contrast media.  4th Ed. American College of Radiology, Reston, Va. 1998   Hope this helps, Nancy Costa CRNI   ----- Original Message ----- From: Lynn Hadaway To: Kimberly Sutters ; [EMAIL PROTECTED] ; [EMAIL PROTECTED] Cc: Kimberly Sutters Sent: Saturday, November 19, 2005 1:01 PM Subject: Re: CT Contrast Extravasation Immediate application of cold for anything that is hypertonic. Vitrase, a brand of hyaluronidase, is available now, but not aware of any published case reports. If severe, I would get a surgery consult as there could be compartment syndrome or necrotic ulcer depending on the volume and type of contrast. Lynn At 1:27 PM -0800 11/18/05, Kimberly Sutters wrote: Content-Type: text/html Content-Transfer-Encoding: 7bit Content-Description: HTML X-NAIMIME-Modified: 1 Dear Colleagues - Are you aware of specific treatment recommendations for the management of a contrast extravasation?  We had a patient with an antecubital PIV who had a significant infiltration during administration of IV contrast with the power injector.   I would appreciate your feedback.   Thanks, Kim     Kimberly A. Sutters, RN, PhD Clinical Nurse Specialist, Surgical Services, Pain Management Children's Hospital Central California 9300 Valley Children's Place (FW07) Madera, CA 93638-8762 (559) 353-5440 (phone) (559) 353-8049 (fax) [EMAIL PROTECTED] Children's Hospital Central California A Great Place to Get Better ------------------------------------------------------------ NOTE: This email and any files transmitted with it are intended solely for the use of the individual or entity to whom they are addressed and may contain confidential, patient health or other legally privileged information. If you have received this email in error please notify the sender by email,delete and destroy this message and its attachments. Any unauthorized review, use, disclosure, or distribution is prohibited. ------------------------------------------------------------ -- Lynn Hadaway, M.Ed., RNC, CRNI Lynn Hadaway Associates, Inc. 126 Main Street, PO Box 10 Milner, GA 30257 http://www.hadawayassociates.com office 770-358-7861