esmolol gtt

[tri-rn]

My pt today had an esmolol gtt with a crummy site - the area became indurated and hard although the IV never stopped working ( of course I moved it as soon as I noticed the issue). A short while later his fingers were dusky and cool (both hands, worse on the old esmolol side).

Possibly related? I can't find anything to make me think so....resp status was ok.

[EMSnut45, BSN, RN, EMT-P]

Just looked up esmolol on Medscape. It states "watch for irritation and infiltration, extravasation may cause tissue damage or necrosis." Also states "Do NOT infuse into small veins or through butterfly catheter."

Hope this helps!

[tri-rn]

Thanks EMSNut...I found that too...I had that pt for 3 days running and THANKFULLY no necrosis - whew!

The "blue fingers" came and went throughout the next day...also found a DVT and he was sent for an IVC, so I'm thinking there must've been some clotting going on in his arms too. They got him started on SQ heparin (he was post hemorrhagic CVA, no way was neuro going to allow a gtt!). It seemed to have resolved today.

The nurse who took him from me the day that happened had blamed the esmolol...which was made me think that way. I didn't really question that she might have been wrong haha!