Dear all,

I am currently involved in the process of evaluating and updating our 
Extravasation P/P.  Earlier this morning I received a phone call from a 
pharmacist at our sister facility requesting any info available on 
extravasation.  It seems there was a "Code" in one of our system areas - 
multiple drugs with vesicant potentials were pushed via peripheral line.  The 
peripheral line was lost but not caught and drugs continued to be pushed.   The 
list of drugs pushed vary as to Wydase or Regitine use as the antedote, as well 
as heat vs cold.   The patient is now in ICU but her arm is "purple" from the 
elbow down.  I have not been able to visualize the site as this facility is 
about 25 miles from us and I am only involved, "as a consultant", because the 
pharmacist there knows that I am involved in the revision of our current 
extravasation policy and was in need of resources.

So, the issue(s) . . .  multiple drugs (Calcium Gluconate, Na Bicarb, Epi, 
Amiodarone, Calcium Chloride), no knowledge of when the line was lost, the line 
was pulled without aspiration or expression, questions as to treat with 
antedote, if so, which antedote, heat vs. cold . . .

Photos are to be taken, documentation should be up to standards from this point 
forward, ect.  But....  what is your process if the above occurs?  

Naturally, you and I will all agree that things should have been done 
differently from "go", but that didn't happen.  Have any of you any experience 
with multiple drugs and the lack of knowledge as to what has 
infiltrated/extravasated?  What did you do?  How did you handle it?

Thanks in advance!

Lorrie Fender, RN
Georgetown Memorial Hospital
Georgetown, SC

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