What is the treatment for extravasation?

Treatment of a vesicant extravasation includes immediate cessation of infusion, aspiration of as much extravasated drug as possible through the still-intact catheter, and attempts for the aspiration of the extravasated agent in the surrounding tissue. This aspiration may help to limit the extent of tissue damage.

How is extravasation of norepinephrine treated?

Depending on the size of the extravasation, bring 5 to 10 mg of phentolamine to the bedside. This will need to be reconstituted, and further diluted to 0.5 mg/mL in normal saline. Treatment of the extravasation will involve the nurse administering the phentolamine intradermally around the site of the extravasation.

What is the first treatment for extravasation?

At the first sign of extravasation, the following steps are recommended: (1) stop administration of IV fluids immediately, (2) disconnect the IV tube from the cannula, (3) aspirate any residual drug from the cannula, (4) administer a drug-specific antidote, and (5) notify the physician (Fig. 1).

What is the antidote for epinephrine extravasation?

Phentolamine. Phentolamine is an antidote that will counteract the effect of vasoactive agents such as dopamine, epinephrine, norepinephrine and phenylephrine. These medications result in vasoconstriction via stimulation of alpha-receptors.

Is there an alternative treatment for vasopressor extravasation?

Alternative Pharmacological Management of Vasopressor Extravasation in the Absence of Phentolamine Vasopressor extravasation is a rare adverse drug reaction that can lead to tissue damage, ischemia, and necrosis of the affected area when vasopressors are administered peripherally.

When to use hyaluronidase after a vasopressor extravasation?

Administered as soon as the extravasation is detected, even if the area initially looks just a little white or OK. Should see near immediate effects; otherwise consider additional dose. Now pull the catheter. May cause systemic hypotension (but they should be on pressors at another site) Dilute Hyaluronidase will be used to flush out the drug.

Is there a systematic review of peripheral vasopressors?

Loubani & Green published a systematic review of peripheral vasopressors (10.1016/j.jcrc

Which is the best treatment for extravasation injury?

Knowledge of the mechanism of extravasation‐induced tissue injury, agents for reversal, and appropriate nonpharmacologic treatment methods is essential. The best therapeutic agent for treatment of vasopressor extravasation is intradermal phentolamine. Topical vasodilators and intradermal terbutaline may provide relief.