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- by butofcourse Jul 26, '06Hello everyone,
I'm hoping some of you have experience with treating Dopamine Infiltrates. New literature I found indicates that when injecting Regitine into the infiltrate site, the needle must be changed each time you inject at a new spot in the area. Our staff are questioning if this is actually necessary since this is not the practice when infiltrating a site with xylocaine, for example. Can anyone help me with rationale?
How do you all treat a dopamine infiltrate? I'm trying to compare practice with current literature in the pharmacy world...Last edit by suebird3 on Jul 26, '06
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- Jul 26, '06 by TennRN2004Quote from butofcourseRegitine given in 10 SQ injections around the infiltration site.How do you all treat a dopamine infiltrate? I'm trying to compare practice with current literature in the pharmacy world...
- Jul 26, '06 by jmgrn65Quote from TennRN2004Regitine given in 10 SQ injections around the infiltration site.
- Jul 27, '06 by dorimarYes, but i have never changed the needle with each SQ poke. Did the lieterature give a rationale for this? I really am interseted, because i want to be using best practice.
- Jul 27, '06 by dorimarCan you please place a link to the research?
- Jul 27, '06 by TennRN2004I don't know the actual hard scientific rational, but from a common sense standpoint, I think the reasoning for switching needles before each injection is to ensure you have a clean needle with just the regitine and no reminants from the dopamine you could be injected into tissue, this making the infiltration over a larger area. The way I think about it is you have the dopamine in the tissues you're wanting to treat with the regitine. If you use the same needle, on the 10th injection you've been penetrating skin that has dopamine then moving to a different site on the skin taking more dopamine there. If you change needles, you have regitine and only regitine you're injected each time with the "clean" needle. The pictures of dopamine infiltration are very ugly, and patient's can end up needing skin grafts, even amputation when an infiltration is not assessed/intervened quickly. I know in my own practice, I always cringe when we have a patient on dopamine with a PIV, I would prefer a central line for that type of infusion. If a PIV is all I have, I document that my PIV has good blood return and is infusing with no s/s infiltration and assess my IV site much more frequently than I would if I just had NS at KVO.
- Jul 27, '06 by OtessaI've given Regitine and had a new SQ needle for each injection...............
- Jul 28, '06 by butofcourseThank you so much, TennRN! You put into words what I was having trouble wrapping my arms around!
For the rest of you, I will make a more concerted effort to retrieve the exact reference.
Thanks for all your responses!!!
- Jul 29, '06 by Renee_RNI have administered Regitine into a Dopamine infiltrate on several occasions. I use aseptic technique and do not change the needle.
- Jul 30, '06 by TennRN2004Quote from Renee_RNLike I say, I don't know the hard evidence to support doing it. However, it is our hospital policy when administering it to change the needle. My response above was based on why it makes sense to me to do it. I probably would not have given it a thought if the hospital policy didn't state for us to do it.I have administered Regitine into a Dopamine infiltrate on several occasions. I use aseptic technique and do not change the needle.