Hot pack or Cold pack for CT contrast infiltration? - Page 2

At our hospital we advise pt's to use Cold Compresses q4hrs x 20 mins. for 24hrs. then warm compresses q4 for 24hrs. : of course this is while awake. We also advise the pt. to elevate their arm when possible. If 100cc or greater of IV contrast infiltrates, then our protocol requires a Plastics consult. I hope this helps. We also do a follow-up phone call in 24hrs to check on the pt's condiion.

The ACR (American College of Radiology) acknowledges that there is no medical evidence to support cold or warm compresses for infiltrations. On their website they have a "Manual on Contrast Administration" which is downloadable and a great reference tool.

Our facility applies warm compresses initially, has the pt keep their arm elevated for the first 12-24 hours. The patient is then instructed that they should apply compresses for comfort (their choice, heat or cold) 15 minutes on and 15 minutes off.

We track all infiltrates with physician follow-up with those infiltrates that are less than 100cc's. If any infiltrate results in blistering, is 100cc's or greater, or patient has any s/s of compromised profusion with potential for tissue sloughing they are referred to a plastic surgeon for evaluation and follow up.

Hope this information is helpful.