I had a question from one of our Clinical Educators:

Are cool/cold packs still the standard of treatment for infiltrations;

and warm packs for phlebitis?

Thanks,

Tanya

Such as list of osmolarities

Such as list of osmolarities would need to be custom made for your facility. The osmolarity depends upon how the drug is diluted - the specific type and brand of solution used and the quantity. Unfortunately this information can not be found in any place that I know about. Then osmolarity is not the issue for several drugs - pH is the issue. Your message mentioned Dilantin and this has a pH of 11-12. No research has looked at thermal manipulation for pH problems but we do have limited research on healthy volunteers with hyperosmolar solutions. Lynn

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

Does anyone have a list of

Does anyone have a list of common drugs and their osmolarities. I would like to laminate a list to all units for quick reference ie. Heparin infiltrate use Heat  Dialntin use ice etc

Infiltration and Extravasation treatment

For minor infiltrations, no treatment may be required.

For major infiltrations, treatment depends on the osmolarity of the infiltrated drug. For hyperosmolar solutions, heat makes the situation worse. So cold is preferred.

For isotonic or hypotonic solutions, use heat or cold depending upon what makes the patient feel better.

For extravasation, again go by the tonicity of the solution, with 2 exceptions. Vince alkaloids and epipodophylotixins require heat and all others will usually receive cold.

 

Phlebitis is heat application. Lynn

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