Looks like an extravasation of cisplatin to me. Could be from an improperly placed or partially dislodged port needle. Is this the subclavian site? If so, it could also be catheter fracture from pinch off syndrome with leakage. Did they get a blood return when using the port? Lynn
I suspect this is an ethyl chloride injury. If you look at the scab pattern, you can see that the lower margin has rounded areas. The office where he got his chemo uses ethyl chloride. It looks to me like instead of moving the nozzle quickly on the skin, it was stationary for too long in a variety of targets. The port was fine post insertion and was used 3 days later for the platinol (when injury occured).
Patients receiving it for radiation synergy usually get a very low dose--around 35-50 mg. Platinol is generally diluted in a 250 bag so this concentration is certainly less than 0.2 mg/ml. ONS indicates that 0.5 mg/ml might be a problem, but I don't think that an extravasation was what happened. His port was quite visible.
Neither patient nor wife reported any problems during the infusion.
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Here's the answer:
I suspect this is an ethyl chloride injury. If you look at the scab pattern, you can see that the lower margin has rounded areas. The office where he got his chemo uses ethyl chloride. It looks to me like instead of moving the nozzle quickly on the skin, it was stationary for too long in a variety of targets. The port was fine post insertion and was used 3 days later for the platinol (when injury occured).
Patients receiving it for radiation synergy usually get a very low dose--around 35-50 mg. Platinol is generally diluted in a 250 bag so this concentration is certainly less than 0.2 mg/ml. ONS indicates that 0.5 mg/ml might be a problem, but I don't think that an extravasation was what happened. His port was quite visible.
Neither patient nor wife reported any problems during the infusion.