Dopamine infiltration, how long the site will be necrotic?

IVRUS, BSN, RN · Apr 27, 2015

just wondering if Dopamine is infiltrated, how long it takes for the site to appear necrotic? It has been 7 hours, the site is not discolored and pt has no pain, but I heard it takes 24 hours. just worried. the site is bruised, but bruise did present when IV had good blood return. thanks.

Please remember that Dopamine is a Vesicant, and therefore if the vessel broke down and allowed this medication to go into the tissues, you have an EXTRAVASATION, not an infiltration. Extravasations of vesicant medications can lead to tissue blistering, sloughing and necrosis, but it is not readily apparent in most cases. That is why this needs to be a continuing event as the worst case scenerios may not show up for 1-4 weeks s/p extravasation.

iluvivt, BSN, RN · Apr 27, 2015

Thank you I was just about to say the same thing that it should be characterized as an extravasation. Please look at your extravasation policy if you have one. Was it treated with Phentolamine,thermal application or any dispersal agents.? Once this occurs it is imperative that you follow infusion care standards so that if the damage does occur to the patient you have proof by your actions and documentation that this standard was followed. I can not underestimate the importance of this as the patient often gets lost in the mix as their care changes hands from one healthcare worker to the next. As IVRUS stated this requires ongoing monitoring and the teaching provided to the patient must be documented.

The best advice I can give you is to get a central line as soon as feasible in patients receiving any of the vasoactive drugs that can do this. In the meantime pick a vein that is large not in an area of flexion....use the smallest catheter you can...and monitor that site very carefully and change the site at the first sign of any trouble..