Iv infiltration/extravasation from prbc transfusion

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We have one baby in our unit who suffered from extravasation from PRBC TRANSFUSION. She is now with hematoma around the prick site.I tried to search, but the the topic is seldomly discussed. So I am asking for your opinion regarding this matter.

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hmm...seems strange to me. Only because ive never experienced extravasation occure to a non vesicant agent or substance. Are we absolutely positive that PRBCs was the only thing being infused, which im sure it was but hmm idk ill have 2 research it

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Specializes in Infusion Nursing, Home Health Infusion.

That is considered a 4 + infiltration and not an extravasation.. An extravasation is the inadvertent administration of an IVF or medication that is known to cause tissue damage should it get out of the vein and into tissue. The BEST treatment for any of these is PREVENTION..PREVENTION.... PREVENTION!!!! If there is a Lawsuit the NURSE always loses as it is our JOB to know what we are giving..making sure the VAD is working correctly and is in the vein and to know the frequency of monitoring....This problem is particularly troubling in the pediatric population. so in this case you will need to monitor very well to make sure that no damage occurs..you will need to monitor for compartment syndrome..so there is no nerve damage.and since the patient may not be able to report symptoms you will need to monitor that site really well and document really well...since treatment can be contoversial in a lot of these cases you will see both heat and cool recommended...I elevate to pts comfort level..that is what recent studied recommend.....for isotonic or near isotonic heat is OK for hypertonic use cool...

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Specializes in NICU, PICU, educator.

I have seen a few blood infiltrates...we just monitor them, they will absorb on their own usually. It will start to look like a scab after a few days and then reabsorb.

As for watching sites...it can happen to anyone...and it can happen quickly or insidiously. A lot can happen in an hour before you check it again.

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thanks a lot for the info's. It is true that prevention is always the best treatment! In our case in our unit, the site really dont look good. Site appears to be like hematoma in apperance. We will try elevation and cold pack application.

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Specializes in NICU, PICU, educator.

Remember that you should always have a doctor's order for any heat or cold application, according to hospital policy, esp on infiltrates. We have plastics and peds surg that consult and they want specific things.

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I would think it would be just like a hematoma. :confused: After all, isn't a hematoma a collection of blood inside the tissue?

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yes, actually it is really a hematoma. Just that the blood accumulated in the tissue didn't come from any bleeding or external pressure. But it came from the blood transfusion. thanks for all the replies. The site now is 3 days old and it is improving in color and with the conservative management we applied. thanks alot!

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Specializes in NICU.

I have seen many blood infiltrates. They all look so awful but they have all turned out fine with no treatment at all. The parents really take it hard because they look so bad. Check sites very frequently with prbc infusions and hopefully you can catch it before it gets too ugly

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Our patient with PRBC infiltrates really improved a lot with our conservative management. Color improved dramatically. Yes, meticulous assessment is really helpful.

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