The other day I saw something strange and I was wondering if anyone here has seen anything like this before and can give me any info.
The patient was a baby in the ER. A nurse had placed an IV on the previous shift and IV fluids were infusing. I went in to assess the patient, unwrapped the arm to check the IV site and noticed the entire arm where the IV was was a purplish red color and there was a ring of petechiae on the upper arm where I assume the tourniquet had been placed. The discoloration went all the way down the arm and there was definitely a really defined line between the normally colored skin and the discolored skin. There was no infiltrate and no tourniquet was left on the arm. There was good capillary refill, a strong radial pulse and his hand was warm. It looked awful and the mom was really upset. The entire arm looked like one big bruise.
Of course I had the doc come in and check it out and he had never seen anything like that either. Does this happen when the tourniquet is left on too long or is applied too tightly? Are babies particularly vulnerable? I have never seen this before even on patients who have mistakenly had tourniquets left on them for an hour or more. Does elevating the arm or applying cold or heat help in this type of situation? Should I have d/c'd the IV (it was flushing fine and the doc said it was ok to leave it). Any info would be appreciated especially on how to prevent this!