Nitropaste for IV infiltration?

[queenjulie, RN]

I just saw a post from several years ago about amiodarone infiltration possibly causing severe edema, redness, and pain in a peripheral IV site (the entire arm was edematous). A respondent said:

"Our Hospital Protocal Is To Apply A Thin Layer Of Nitropaste To The Site Followed By A Warm Compress For 20 Minutes Q 6 Hours."

Since it's so old, I wanted to start a new thread and ask why you would apply Nitropaste to the site. I'm a student, so I know very little about Nitropaste other than that it's a vasodilator. Would applying it to the site help increase circulation and the immune response, which would make the redness and edema go away faster? Or would increasing blood flow just make the edema worse? Would you do this if your patient had a serious problem with an infiltration?

[iluvivt, BSN, RN]

I have seen Nitro paste used as an off lable use for the treatment of extravasations of the the sypathomimetics (epi neosynephrine...dopamine) when phentolamine was NOT available. What we see from Amio is a very severe phlebitis and if not removed at the first sign of trouble the tissue also can become very painful. treatemtn of extravasations can be very controversial with no clear cut treatments for many possible scenarios...so I would say this is an off label use in an attempt to throw something at the problem. The BEST treatment for extravasations is PREVENTION.