How are infiltrated or extravasations managed in your NICU? Documentation,photos,notification of neo or a practioner, wound care, who can treat, etc.
jennylee321 412 Posts Feb 4, 2018 Different at different places I've worked. Infiltrated, I just take it out and monitor it. If I'm more concerned about it I show the doc. For a bad extravasation- document a detailed assessment of it, measurement of limb and area affected, photos, hyalurinadase (if indicated), wound care as needed and plastics referral.
BeccaznRN, RN 758 Posts Specializes in NICU, High-Risk L&D, IBCLC. Has 16 years experience. Feb 4, 2018 Our vascular access team is involved with all infiltrates and extravasations. They perform initial assessments, make recommendations for treatment, and follow until resolved.
vintage_RN, BSN, RN 717 Posts Specializes in NICU. Has 9 years experience. Feb 4, 2018 We check our IV sites Q1h, if it looks infiltrated we stop the IV and get one of the IV nurses (usually charge or admits) to come look at it and restart if needed. If it's actually a case of extravasation, it depends on the case - if the med/fluid causes an IV burn then we usually give Hyaluronidase.
allstressedout1 32 Posts Feb 4, 2018 And who would be responsible for injecting the Hyaluronidase in your unit?
Leader25, ASN, BSN, RN 1,316 Posts Specializes in NICU. Has 40 years experience. Feb 4, 2018 we use hyalroudase immediatlt one ml in 5 spots divided 0.1 ml -0.2ml , works great.
allstressedout1 32 Posts Feb 4, 2018 Who decides if it needs treatment and who does those injections.
NICUmiiki, DNP, NP 1,774 Posts Specializes in Neonatal Nurse Practitioner. Has 8 years experience. Feb 5, 2018 In my unit: the physician or NNP decides whether hyaluronidase is warranted. The RN administers it
Olivia., BSN, RN 8 Posts Specializes in NICU. Has 6 years experience. Feb 5, 2018 At my facility, it's the RN taking care of the baby at the time that injects the hyaluronidase. I'll call the house officer for the baby & tell them first/ask for an order.
Leader25, ASN, BSN, RN 1,316 Posts Specializes in NICU. Has 40 years experience. Feb 13, 2018 Who decides if it needs treatment and who does those injections.The nurse taking care of patient will inform the MD of the need and why,get an order if needed and administer it and reorder replacement hyalrounedase from pharmacy and restock it.If it is very bad ,broken skin etc-(get a laywer ) the MD assesses need for plastics consult.I have seen vasoldilating cream used by some doctors.
