IV Infiltration

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Specializes in NICU.
Wydase was discontinued because of Mad Cow disease. It was made from bulls testicles.

I often wonder how things get invented in this world. How in the world, or should I say WHY in the world, did someone take some bull testicles and decide to make medication out of it??? How does that kind of invention HAPPEN? :lol2:

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Wydase is being made again. Yeah! Have your pharmacy check into it!

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Gotta go with the Q1hr...D10 and higher should only be given via a central line, or you are risking a severe infiltrate...we have used wydase also....if real bad...since it is too late for wydase...how about silvadene.

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Specializes in NICU.
Gotta go with the Q1hr...D10 and higher should only be given via a central line, or you are risking a severe infiltrate...we have used wydase also....if real bad...since it is too late for wydase...how about silvadene.

Actually, it's anything HIGHER than D10 that needs a central. D10 is fine via peripheral line. I work in a Level 2 where we don't do UAC/UVCs, so we do everything via PIV or PICC/PERC. The only kids who get PICCs are kids who've had long history of feeding intolerance, NEC, etc, something that prevents them from advancing to full feedings within a reasonable period of time. We will do a couple weeks of TPN and Lipids by PIV unless we run out of sites. We are very anal about checking them at LEAST every hour, and we remove and replace them at any sign of the slightest infiltration. That I know of, we haven't had any kids needing any special products or plastics or anything because we just don't allow them to get to that point. But our smallest kids are not usually less than about 800-900 grams unless they are severe IUGR, so I can't speak for smaller micro-preemies.

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There is what I guess would be called a "generic" wydase" out there, we keep it on our unit for the unfortunate IV burn we do experience. :o (Thankfully it is not nearly as often as it could be since we do not use PICC/PCVC lines (which ever term you prefer) but PIVs once the UAC/UVC comes out.)

Depending on the practioner they injet the "wydase" around the area but I have known to have some ask to have the catheter left in so they can inject some through the catheter as well. It can work really well or not so well but there is still some amount of "burn" left to treat for a while depending on just how severe it was and with what is the question.

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Specializes in Pediatrics, Womens services..

This is my first time @ allnurses and I am really excited. Does anyone know approx. how long a pediatric iv would have to have been infitrated for tissue necrosis to take place with D5 1/4 ns @ 33cc/hr running? An RN on my unit was fired, when it may have been the next shifts error.

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Specializes in Neonatal ICU (Cardiothoracic).

Unfortunately it only takes a few cc's of infiltrate to cause necrosis. It's not really the focus of this forum to speculate on who's at fault, especially when it involves the legality of a nurse being fired.

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Specializes in NICU.

We are not able to use hot packs anymore due to burns and we cant do much for infiltrates. I have not seen a necrosis from a inflitrate but we try to elevate and assess and reassess.

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SSD cream is toxic to newborns. Look it up. Apply Multidex powder mixed with Solosite wound gel to gauze or Nu-gauze plain packing

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Specializes in NICU, PICU, educator.

We use hydrogel to the area after consulting with wound management. Have had great results with it. Never apply heat!

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I've been off orientation for about 4 months and have only worked in this one NICU, so I'm a bit curious about all these interventions. Although I've had a few PIVs go bad, I've never seen or heard anyone talking about giving these medications or having to elevate the limb. How severe does it have to be to warrant these interventions?

I can think of several instances where I noticed my baby's arm was starting to get puffy during my hourly checks and brought another RN or the charge nurse over to confirm and help me start a new IV. None of them have ever had blistering or obvious skin damage, just swelling, and maybe an increased circumference of 0.5-1 cm (I've gotten paranoid and started measuring a baseline circumference near the insertion site on babies with a PIV when I do my assessment). None of these other nurses have suggested that the babies need other interventions, and when I come in the next night the affected limb looks fine, but I just want to make sure I'm doing all I need to do. Maybe I'm using the term infiltration too loosely? I don't want to chart that the line infiltrated and then look like I didn't do anything other than start a new IV.

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Specializes in NICU, Infection Control.

The OP of this thread basically erased his/her post. The thread started >1 yr ago. I'm going to close this.

If you want to discuss the topic, could you please start a different thread?

thanks

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