I was called to restart an IV on a pt. whose peripheral line had infiltrated during a blood transfusion via a warming device.  She had a nice size "egg" on her forearm which was very uncomfortable.  I have looked through the liturature and can only find "according to your facitity protocol & policy".   We don't have one that includes this scenerio.  Do you use warm or cool compresses?   Some claim warm---for comfort & absorption (pH & osmo within range),  others say cool (prevent necrosis & clotting).  What do you do? and on what liturature did you base your protocol?     Thanks,  Denise

Yes we also use cool

Yes we also use cool compresses since the use of warm compresses in some situations has become controversial , especially moist heat. I need to check the AABB technical manual to see if they have a specific recommendation. Your blood bank should have a copy as well. We elevate if this increases the patient comfort. The best practice of course is to avoid these situations and avoid areas where it is difficult to detect infiltration, such as the ACF.

 

 

All blood should be graded

All blood should be graded as a stage 4 extravasation injury. I have never seen any case reports of how a blood extravasation injury should be treated. My professional opinion would be to lean toward use of cold rather than heat. Heat will bring the extravasated fluid into contact with more tissue, possibly increasing the risk of tissue damage.  

 

Lynn Hadaway, M.Ed., RN, BC, CRNI

www.hadawayassociates.com

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861