Hot pack or Cold pack for CT contrast infiltration?
- 0Apr 10, '07 by KEVIN88GTI'm guessing cold pack as contrast is an irritant to tissue...am I wrong?
Which one do you use? For how long? And how do you follow up?
- 0Apr 13, '07 by dianah, ADN Senior ModeratorThere is no standard that I can find . . we always applied warm compresses (the patients reported it felt good, and we noted decrease in swelling of the extravasation area after compress application). Other facilities applied cold/ice.
Depends on the amt of extravasation as to what the Radiologist would recommend for f/u; he may have had the pt return the next day so he could assess the area. Large extravasations may require Plastic Surgery consult.
Below are three links that might be helpful to you. Review the literature (what does the American College of Radiologists recommend?), then write your policy. BTW, I did the Google search with the words "contrast extravasation treatment."
Good luck! --- D
- 0Apr 13, '07 by dianah, ADN Senior ModeratorHmmmm, you might try another search . .
I tried to give links to literature, to support evidence-based practice.
My first-hand experience was using warm compresses (preceded by confirmation of a good IV and CAREFUL observation of the site during infusion, so you can halt the injection if you see swelling), thinking the warmth would dilate capillaries = increasing blood flow to the affected area, to aid in absorption of the contrast.
Others I've spoken with advocated cold compresses/ice packs, to decrease inflammation at the site.
I preferred the warm compresses because the pts reported the site felt better and the swelling diminished after 20-30 min of application.
I'm interested to hear any other opinions/experiences, or see any pertinent links.
- 0Jul 14, '07 by DutchgirlRNWe had a pt this week that had two extravasations back to back. Great 18g in the AC, flushed great. Infiltrated about 10ml. Started a new IV on the other side in the forearm, flushed great. Intiltrated about 5-10m. I had the radioligist come out and have a look. He said her veins just couldn't take it and go ahead and do the study w/o contrast. He said our protocol was heat for 30 minutes then ice and told the patient to keep alternating at home. She came back the next day and no signs of extravasation were present.