Treatment of drug extravasation

Letting the drug enter our body through infusion is more conducive to the body's absorption. Therefore, many friends choose intravenous infusion during treatment. However, intravenous infusion also faces a problem, which is the extravasation of the drug solution. Generally speaking, for experienced nursing staff, drug extravasation rarely occurs, but if it does occur, we hope that everyone knows how to deal with it.

Nursing strategies for drug extravasation

1. Small-scale extravasation: (1) If the extravasated drug solution has little irritation to tissues and is easily absorbed, such as ordinary solutions and auxiliary treatment solutions, you can use wet hot compresses, or wet compresses with 95% alcohol and 50% magnesium sulfate, and the swelling will subside quickly. If there is not much drug solution left, you can observe while applying wet compresses. If extravasation stops, you can persist until the infusion is completed. (2) The injected liquid is a vasoactive drug. Although local swelling is not obvious, redness, paleness, and pain are obvious. The injection site must be changed immediately. The local area can be continuously wet-compressed with 95% alcohol, and the redness and swelling will disappear quickly.

2. Large-scale extravasation: If the injected drug solution is highly irritating, such as in the limbs, local immobilization, elevation of the affected limb, continuous wet compress with 50% magnesium sulfate or 95% alcohol, combined with physical therapy, local blockade, and corresponding drugs can also be used to antagonize. For example, extravasation of vasoconstrictor drugs such as dopamine, metaraminol, and norepinephrine can be treated with phentolamine, nitroglycerin, and dexamethasone; calcium supplements can be treated with 50% magnesium sulfate and scopolamine (654-2) wet compresses. It is also said that potatoes and ginger can be used for external application.

3. Extravasation of chemotherapy drugs: When extravasation of chemotherapy drugs occurs, the dripping should be stopped immediately, and the drugs should be diluted by subcutaneous injection of normal saline, and cold compress should be applied locally to prevent local pain, swelling, and necrosis.

.4. Local blisters caused by extravasation of drug solution: If the blisters are small and not ruptured, try not to puncture them, and you can apply alcohol-free iodine tincture externally; if the blisters are large, disinfect them with iodine tincture and then use a sterile syringe to extract the exudate in the blisters, then apply alcohol-free iodine tincture externally. It is also recommended to use egg white for external application.

Various treatment methods

Cold compress

It is suitable for the extravasation of anthracyclines such as daunorubicin, doxorubicin, epirubicin, paclitaxel, docetaxel, and other chemotherapy drugs. Local cold compress can cause vasoconstriction and decrease the metabolic rate of tissue cells, thereby reducing the amount of drug extravasation and drug uptake by normal cells, thereby achieving the purpose of reducing the scope of leakage. You can apply cold compresses (4℃～6℃) locally for 48～72 hours, once every six hours, each time for 20～30 minutes.

Heat

It is suitable for the treatment of extravasation of plant alkaline anticancer drugs such as vincristine, vinblastine, isovinblastine, vinorelbine, oxaliplatin and other drugs. Local warm compress can cause vasodilation, accelerate the absorption, dispersion and uptake of extravasated drugs, and reduce skin damage caused by drug extravasation. Cold compress must be applied within 6 hours, and hot compress after 24 hours. However, for vincristine and vasoconstrictor drugs, warmth and hot compress should be applied early, and the affected limb should be elevated to facilitate venous return and the absorption of local swelling.

physiotherapy

Far infrared ray 275W 15-30 minutes/time, 2 times/day

Ultrashort wave 30 minutes/time once a day, for stage II and III wounds after dressing change

Medicated compress

1. 50% magnesium sulfate wet compress

50% magnesium sulfate wet compress is suitable for drugs that cause extravasation of cationic solutions, such as 10% potassium chloride, 5% sodium bicarbonate, and 10% calcium gluconate. Method: Soak 4 layers of gauze with 50% magnesium sulfate solution and cover the affected area, then cover with a layer of plastic film. Change the compress every 4 to 6 hours and continue.

2. Ruyi Golden Powder + Sesame Oil

External application of Ruyi Jinhuang Powder plus ice compress: The specific method is: take an appropriate amount of Ruyi Jinhuang Powder, mix it with herbal tea water (you can also use vegetable oil or honey), then evenly apply it on gauze and apply it to the affected area, and seal it on the gauze with a layer of plastic film to allow it to continue to work. Several times a day, until completely cured.

3. Crush the cactus flesh + borneol

Cactus external application treatment (suitable for hyperosmotic drugs)

Method: Take about 100 grams of fresh cactus each time, remove the thorns, wash and mash it, wrap it with clean gauze and cover the affected area, 1 to 2 times a day.

4. Phentolamine local wet compress (suitable for vasoconstrictive drugs)

Method: Take 1 ml (10 mg) of phentolamine and add 50 ml of normal saline. Soak 4 layers of gauze in the solution and cover the affected area. Apply wet compress for 30 minutes each time, once in the morning, noon and evening every day. Continue to apply wet compress for 3 to 7 days.

5. The potato external application method is suitable for external application of various medicinal liquids.

Wash the potatoes, cut them into transparent slices, stick them on the swollen area, fix them with tape, and change them every 1-2 hours.

6. Green tea

7. Liushen Pills + Honey