mbt laarzen Case of intravenous extravasation of e

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Case of intravenous extravasation of epirubicin hydrochloride in patients with partial skin necrosis caused Nursing

Aseptic inflammation can cause, if not in time often cause severe local tissue inflammatory reaction and lead to skin ulcers, or even dry necrosis, our hospital in recent years, intravenous injection of tumor patients lose chemotherapy, because individual patients differences in mission, operations and other factors, our patients in hospitals, l peripheral intravenous chemotherapy due to liquid leakage lead to local inflammation, tissue necrosis of the cases now reported as follows. Clinical data Case 1: a male, 72 years old, hospitalized with lymphoma, chemotherapy, previous history of diabetes patients, the nurse executive to be in the right hand back at the doctor's advice to establish venous access, normal saline 300mL + epirubicin (epirubicin hydrochloride ) 60mg, to 2O ~ 3O drops / rain to the intravenous drip, l5min found the patient after the infusion room nurses visit site swelling, wash immediately stop transmission, the replacement of infusion site, and inform the doctor, wet seepage area covered with magnesium sulfate. ld troubles infusion site has 3cm × 1.5cm size of the blisters, the local suction, physiotherapy,[link widoczny dla zalogowanych], patient infusion site skin scar, the finger was normal, l weeks after the patients requested discharge. Discharged JIJIf, I hand back the heart are still swelling, local self-deposited drugs at home after 2 weeks in patients with symptoms 『JlI, back to the hospital. After a medical examination, the patient part of the back of the hand skin tissue necrosis, accompanied by surrounding tissue swelling, local inflammation, the index finger, middle finger, ring finger and activities are governed by. After debridement, the flap back of the hand to be in hospital a month, the patient cured. Analysis 2 (1) thousand nurses responsible for the heart is not strong, there is no more to do before the chemotherapy drug mission, if it is found fluid leakage should promptly report about a doctor on duty to prohibit the heat. Note not account for unknown search patrol wards in time for the occurrence of the main reasons. (2) lack of knowledge of patients to chemotherapy, the chemotherapy drugs as an ordinary and found a small amount of liquid leakage, mistaken for little effect, continue intravenous drip, do not want to repeated venipuncture. (3) health care workers on the chemotherapy drug leakage not handled properly, causing local tissue damage, ulceration, or symptoms plus grate. (4) can not be timely inspections of infusion patients, care is not in place, patients are not carefully observed. (5) on account of lack of patients after discharge, the guidance is not in place, resulting from the deposition of drug in patients with localized infection. 3 emergency measures (1) Once a leakage of chemotherapy drugs, they should immediately stop injecting chemotherapy drugs, can be connected to retain the syringe needle, try to drain the subcutaneous extravasation Withdrawing drugs, and then remove the needle. (2) occurs after extravasation of chemotherapeutic drugs promptly notify the competent doctors and head nurses. (3) with 0.2% lidocaine local block, either dilute the liquid leakage of the liquid and prevent the spread,[link widoczny dla zalogowanych], but also play a role in pain and closed the amount of fluid can be prepared as needed. (4) extravasation can be used within 24h of local ice cold, cold period of observation should be strengthened to prevent frostbite, cold make blood vessels, reduce the liquid to the surrounding tissue proliferation. (5) to avoid local compression patients, extravasation of local swelling can be severe with 50% magnesium sulfate wet compress. (6) Strengthening the shift relief system, close observation of local changes. (7) Where in the input should be repeated chemotherapy to patients and their families and the promotion of drug side effects precautions to obtain the cooperation of patients. ( Cool

to be synchronized when the chemotherapy drugs enter the wet packing,[link widoczny dla zalogowanych], protecting blood vessels. 4.1 4 nursing patients in the chemotherapy drug to be doing the preparatory work (1) To explain the details of chemotherapy to the treatment of patients and their families purpose and attention,[link widoczny dla zalogowanych], to get the patient's understanding and cooperation. (2) Select the appropriate vein, stock options coarse, straight and resilient vein infusion. (3) chemotherapy should be preceded by intravenous access with normal saline to get through to observe the leakage of 5 ~ lOmin no swelling,[link widoczny dla zalogowanych], and then follow chemotherapy. Visits every 15 to 30 minutes observed drug response and infusion needle at the skin with or without swelling, leakage and so on. (4) In the event that leakage of chemotherapy drugs, stop the infusion immediately, retaining the needle, then} l syringe pumping, reduce liquid leakage, local treatment in a timely manner, reducing local tissue damage and pain. 4.2 The use of chemotherapy drugs to patients as possible application of intravenous catheter or PICC use the sleeve trocar needle, to reduce vascular stimulation, while reducing the tax due to the scalp caused by extravasation needle slip, especially PICC may be longer ten intravenous indwelling time, thus reducing the number of r vein, extending the interval between each venipuncture, intravenous fluids to make more convenient, but also reduce the workload of nurses. Attained through clinical view that, to take active preventive measures can effectively reduce the incidence of complications. Received Date】【2008-12-06CHINAFOREIGNMEDICALTREATMENT in the evening I care l37
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