phentolamine, The treatment for extravasation ischaemia

 

 

Treatment of Extravasation1: 

 

A. Notify Senior Medical Officer on duty  

B. Stop the noradrenaline infusion immediately6 

C. Do NOT remove the catheter/needle immediately

. Aspirate as much of the residual noradrenaline as possible,

E. Do NOT flush the line6

F. Outline the extent of extravasation marking on the skin to provide baseline for monitoring

G. The treatment for extravasation ischaemia is phentolamine:  Using a fine needle, subcutaneously inject phentolamine 5 - 10 mg (diluted in 10 mL sodium chloride 0.9%) throughout the ischaemic area* as soon as possible after extravasation is noted6. *identified by its cold, hard, pale appearance  

H. Once the wound has been irrigated and/or an antidote has been administered, the peripheral intravenous catheter should be removed and replaced, as needed, at a site remote from the site of extravasation.8

I. Request plastic surgery team review in-hours if extravasation occurs.

J. Log notification of incident in the Incident Information Management System (IMs+) 

 

https://www.seslhd.health.nsw.gov.au/sites/default/files/documents/Medicine%20Guideline%20-%20Phentolamine%20in%20the%20treatment%20of%20dermal%20necrosis%20or%20sloughing%20following%20extravasation%20of%20peripherally%20administered%20noradrenaline%20%28norepinephrine%29.pdf

 

 

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