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Be Careful with an IV Line

机译:小心静脉输液

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摘要

Obtaining an intravenous (IV) access is a simple procedure which can be done in almost any hospital setting. One of the most dreaded complications of this procedure is an inadvertent intra-arterial cannulation. This can result in an accidental injection of medications intra- arterially, which can potentially lead to life altering consequences. In the hope that these types of events can be prevented, we are presenting a case of a 57-year-old male who underwent bougie dilatation for an oesophageal stricture and was accidentally given medication for pain management intra-arterially through an improperly placed IV line, which resulted in ischaemia, gangrene and subsequent loss of the hand. Those who try to obtain an IV access should always be on the lookout for possible clues that can prevent an inadvertent IA injection, especially if cannulation is in an area where an artery is in close proximity to a vein; these clues include but are not limited to the following: a bright-red flash of blood in the cannula, pulsatile movement of blood in the IV line, and intense pain or burning at the site of injection. These signs, as well as educating the patient on early symptoms of ischaemia, may allow early action to be taken, to prevent irreparable damage. We always have to be careful when we insert an I.V line.
机译:获得静脉(IV)通路是一个简单的过程,几乎可以在任何医院环境中进行。该过程最可怕的并发症之一是动脉内插管的疏忽。这可能会导致动脉内意外注射药物,这有可能导致改变生命的后果。为了希望能够预防此类事件,我们介绍了一个57岁的男性患者,该男性患者因肉食性狭窄而进行了布吉扩张术,并且意外地通过不当放置的静脉输注线进行了动脉内疼痛治疗药物导致缺血,坏疽和随后的手丢失。那些试图获得IV通路的人应该一直在寻找可能的线索,以防止意外的IA注射,特别是如果插管是在动脉紧邻静脉的区域中;这些线索包括但不限于以下内容:插管中鲜红色的血液闪烁,IV线中血液的脉动运动,以及注射部位的剧烈疼痛或灼烧。这些体征以及对患者的局部缺血早期症状教育,可允许及早采取措施,以防止不可挽回的损害。插入I.V线时,我们必须始终小心。

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