what's the appropriate name for this procedure?

[GingerSue]

when an IV goes interstitial, and the person's hand becomes extremely swollen (the IV is removed), and when the swelling doesn't go down, then staff insert a needle and withdraw fluid from tissues?

What is the proper name for this procedure?

How is it actually done?

And why does the fluid return again the next day (the IV is already gone?)

thanks if anyone knows

[Lacie, BSN, RN]

could this be what the op was talking about?

2. prevention or treatment of dermal necrosis and sloughing following intravenous administration or extravasation of norepinephrine.

for prevention: 10 mg of phentolamine mesylate is added to each liter of solution containing norepinephrine. the pressor effect of norepinephrine is not affected.

for treatment: 5 to 10 mg of phentolamine mesylate in 10 ml of saline is injected into the area of extravasation within 12 hours.

we used to do dimilar to this for dopamine infiltrations, etc. i hated doing it as it took numerous sq injections in one session around the site. we used reglan if i remember correctly. not sure if still done same way. i've never heard of essentially drawing off fluid. they can develope as described above necrosis or sloughing. another would be cellulitis due to the inflammation which can result in significant edema/pallor. very tender and painful to boot. some of the old schoolers may remember this.

[Daytonite, BSN, RN]

The only thing that I can think of that someone would be "sucking out" of a swelling would be pus from an abscess that had formed at the insertion site. Even then, it wouldn't be done by a nurse, but by a doctor.

[chenoaspirit, ASN, RN]

Ive never heard of that. We always elevate the limb and apply warm packs to aid the body to absorb the fluid. I searched online also and couldnt find any info on any such procedure. Maybe this person shouldnt have done such a procedure. As far as the re-swelling, the tissues were traumatized and probably just normal swelling from mild tissue damage, especially if someone was poking around trying to remove the fluid. I dont know, never heard of it.

[GingerSue]

patient said that this was done by a technician

(so I am wondering - what are the qualifications to be a technician, and is this a procedure that requires a physician's order, etc)

[meownsmile, BSN, RN]

I have a feeling the patient was confused about what was being done. Perhaps look at the documentation because this type of procedure whatever it was would have had to be documented to the hilt.

For all you students, i know it sometimes isnt easy to get to but when you have questions about procedures that have been done, check the documentation and the physicians notes in the chart first and see what they say about something that was done. Sometimes its all right there.

Im not trying to discount anyones question, but just give some insight in how to do the inquiry while the answers are still within reach. Sometimes it brings everything into perspective reading the doctors notes/dictation on the patients chart. Ive just noticed in my experience with students they tend to overlook that part of the chart.

[GingerSue]

patient isn't confused, can speak to each staff person by name, knows the date, etc

(what is the basis for labeling this a confused patient?)

[chuckc, BSN, RN]

I remember something like this from my oncology rotation. They had some kind of kit that had something to draw out the chemo solution in case of infiltration into the tissues. It was not shown to me I just remember seeing it.

[chenoaspirit, ASN, RN]

Disoriented: doesnt know name, date, or where they are. Orient x 3: person, place, time.

I agree with the poster who said to check the documentation and physician's notes on any procedures, progress notes. That is where you will find the info. If it was done, it was noted somewhere in that chart (or should be).

[heartICU]

We used Reglan if I remember correctly.

Could you be thinking of Regitine instead of Reglan? I have never heard of Reglan being used for treatment of infiltration.

[Zippedodah]

We don't withdraw fluid, but we will inject NS around an infiltrate to help dilute out the IV fluid that was infiltrated. I've never heard of that. We have used Regitine on vasopressor infiltrates, and we don't use warm packs any more.....plastics told us that this can cause further damage, you just really want to keep it elevated.

[cardiacRN2006, ADN, RN]

If you were drawing off fluid with a needle then it is an aspiration.

Agree with a PP, it is Regitine, not reglan that is used for extravasation of vasoactive drugs.

[Lacie, BSN, RN]

Could you be thinking of Regitine instead of Reglan? I have never heard of Reglan being used for treatment of infiltration.

Sorry was a typo, hey been out for a few years lol. Yes it was Regitine. But I do remember how much I hated doing it when the need arised.