Initial treatment provided by the radiology technologist includes:
- Immediately discontinue the contrast injection when a problem is detected.
- Elevation of affected extremity above the heart
- Removal of any tight fitting clothing above the injection site
- Milk the extravasated contrast toward the heart by intermittent compression of affected site by manual compression or an Ace wrap
- Use caution with application of tight bandages (eg, coban) proximal to the extravasation site
Observation performed by nursing staff includes:
- Typical observation periods depend on patient’s symptoms and site of extravasate. Often, 1-2 hours are sufficient
- Educate patient about signs of tissue compromise, and advise to seek medical attention if needed per UW Health Facts for You (HFFY)
- Hot/cold compresses not specifically indicated, but can be used for comfort.
- Plastic surgery consultation based on symptoms, not quantity of extravasation
Plastic surgery consultation should be considered for any of the following reasons:
- Skin blistering
- Redness or streaks at the injection site
- Altered tissue perfusion (decreased capillary refill in the region or distal to the injection site)
- Increasing pain
- Change in sensation distal to site of extravasation
- Main clinical concern is development of compartment syndrome.
Patient given Health Facts for You (HFFY) by rad tech if responsive, or printed by nursing prior to discharge.