Forum topic

 

I, with two pharmacists, and pedi and oncology nurse educators, rewrote an inactive drug extravasation policy a few months ago, it was reviewed and formally adopted.  NICU wanted to add their policy information (instead of having a separate policy), and so the policy review was recently opened up again.  

I was not informed of at least one of the meetings that was recently held by pharmacy and nursing to go over the policy again, and they had actually RE-inactivated the policy because of concerns they had.

One was:  my recommendation that there was a consideration to photo-document the site (they said "no one does that here", "would need a new procedure to do that")....I do photodocumentation, and we don't need a new policy/procedure (I checked)....anyway.... I'm grinching out of exasperation.  We got that straightened out, and left it in the policy.  IV Therapy will do the photodocumentation for them until they can figure out how to plug a digital camera into a computer.  Ooops - grinching again!

I'll continue with the main question I'm bringing to you (Lynn - one of these day's I'll be able to finish your online extravasation course!!  Especially if the hospital stops wasting my time...) 

The group didn't like the (stop the infusion) and "leave the IV in place until antidote/need for antidote is determined."  Apparently, this information is not in the pharmacy manuals. They are not aware of which antidotes you can instill through the IV as you withdraw it - their position is any antidote that you inject into the tissue subcutaneously does not also need to be instilled in the infiltrated IV as you withdraw it.  That actually makes sense to me, but it also makes sense that any antidote you would inject subQ could be injected into the IV while withdrawing it (once it has been pulled back from vein, which might be difficult to be certain when that occurred) - as long as you weren't injecting so much into the tissue that you were damaging it further.

The group would like to remove the "leave IV in place", and just have the staff immediately remove the IV because they think it would be less confusing.  I read your post earlier in the forum about this issue.  What seems to have been clear, ("leave the IV in place"), doesn't seem so clear now - though much of the lit/texts I've read DO make this suggestion. 

Do you think it would be appropriate to take the "leave IV in place....." out of the policy, and have the nurse "remove IV while attempting to aspirate"?, if the antidote will be injected subQ anyway?

I'd love feedback.  I'm going to go bang my head against the wall some more.

 

Mari