Have you ever infused phenylephrine peripherally?

ShyViolet · Jun 23, 2011

Phenylephrine is a very dangerous vesicant which can cause severe necrosis of the tissues if it extravasates; therefore, it is always to be administered via central line.

That being said, I have had occasions where a patient was crashing and all I had was a peripheral line. In that case, I have given the phenylephrine peripherally, but only until central access could be established.

detroitdano · Jun 23, 2011

This has been covered numerous times. Yes I've run it peripherally. Dead patient, or living patient, you can figure out why it's a risk worth taking to run it without a central line if need be.

MomRN0913 · Jun 23, 2011

I have in an emergency with only peripheral access. You take that necrosis chance until central access can be established.

PaSSiNGaS, MSN · Jun 23, 2011

This is a very idiotic statement considering I am in anesthesia and use phenylephrine through a peripheral IV every day lol. Think about it. That's like saying the norepinephrine your body produces and moves around your body should only be done so in large vessels. Makes no sense. Phenylephrine is an alpha 1 agonist and vasoconstricts.

core0 · Jun 24, 2011

Is there a policy in your hospital for this?

We can run it peripherally for 24 hours. Usually when someone comes up on peripheral access only or as a pressor while we are getting central access.

Penelope_Pitstop, BSN, RN · Jun 24, 2011

Is there a policy in your hospital for this?

Official word is that central access is "recommended." And the highest concentration is 100 mcg/mL. Apparently it used to be quite a bit higher but pharmacy changed things around...perhaps this is reducing the chances of extravasation?

Penelope_Pitstop, BSN, RN · Jun 24, 2011

This is a very idiotic statement considering I am in anesthesia and use phenylephrine through a peripheral IV every day lol. Think about it. That's like saying the norepinephrine your body produces and moves around your body should only be done so in large vessels. Makes no sense. Phenylephrine is an alpha 1 agonist and vasoconstricts.

I've been up for over 24 hours, so forgive me, but what you've said here confuses me. Neo-Synephrine...I was under the impression that it was purely a synthetic compound DESIGNED to be structurally similar to epi. I'm not sure why you've mentioned norepinephrine, as that is Levophed.

Our body also "moves around" Potassium but that is also a nasty nasty thing should infiltration/extravasation occur.

If I've misunderstood, my apologies.

PaSSiNGaS, MSN · Jun 24, 2011

I've been up for over 24 hours, so forgive me, but what you've said here confuses me. Neo-Synephrine...I was under the impression that it was purely a synthetic compound DESIGNED to be structurally similar to epi. I'm not sure why you've mentioned norepinephrine, as that is Levophed.
Our body also "moves around" Potassium but that is also a nasty nasty thing should infiltration/extravasation occur.
If I've misunderstood, my apologies.

I know norepi and phenylephrine are two different drugs. One thing though, phenylephrine is not anything like epi other than alpha 1 properties, that's it. I am basically saying phenylephrine constricts peripheral vessels, giving it in a PIV or a central line really doesn't make that much of a difference and if the IV gets infiltrated it's not a huge problem like many people think. When I brought up norepinephrine I wasn't saying phenyephrine was the same.

nurse678 · Jun 24, 2011

Ok well I had to run it peripherally, didn't feel comfortable with it, but the MD said to. It ran for a good 48hrs plus. One site where it was running, has become reddened, hot, and sore to the touch. One nurse said this will become necrotic and slough off. I switched the IV site every 6-8 hrs, and charted on the site Q 1 hour. But apparently, it takes a while for this to occur, seeing as days after the gtt was stopped, the irritation arises?

IheartICUnursing · Jun 24, 2011

This is a very idiotic statement considering I am in anesthesia and use phenylephrine through a peripheral IV every day lol.

How professional to call a fellow colleague's statement "very idiotic." This website is not for nurses to argue or put down others but for people to ask genuine questions about things we encounter in our profession and to recieve professional, educated and respectful answers. Not trying to start an arguement or anything, but I just thought I'd throw that out there. Oh and sorry in advance if I somehow misunderstood what you were trying to say.

Although I must also add that PaSSiNGGaS is a very clever name since you're in anesthesia lol

nitronymph · Jun 25, 2011

Unfortunately, necessity dictates doing things that are not always kosher. I have run it through a peripheral line only b/c there was no central line established. As soon as one is obtained, definitely change over!!!