Accidental intra-arterial injection.

Abstract

SUMMARY Accidental intra-arterial injection of intramuscular antibiotic preparations is described in 3 cases in infants. In 2 benzathine penicillin was injected, and in 1 rolitetracycline. The clinical features are dominated by arteriolar obstruction which produces gangrene of the most severely affected limb. In addition, neurological involvement occurs when vessels to nerves or spinal cord are involved. The anterolateral aspect of the thigh is preferable to the buttock as a site for intramuscular injection, and a short (2.5 cm) needle should be used to minimise the risk of intra-arterial injection.

Hyperacute paraplegia and neurovascular (immuno vasculotoxic) catastrophe of nicolau syndrome: Primum non nocere

“…[9] Some other authors hypothesized that penicillin suspension injected into the superior gluteal artery under high pressure could flow retrograde into the internal iliac artery and then to the aorta, leading to the obstruction of the lumbar spinal arteries. [61011] In the thoracolumbar region, all of the blood supply to the spinal cord is derived from a single artery from the aorta, the artery of Adamkiewicz. The retrograde flow could extent further up the aorta to the level of the artery of Adamkiewicz.…”

Accidental Intra-Arterial Injection during Test Dose of Injection of Benzyl Penicillin: Complications and Management—A Case Report

“…During administration, with moment of part where drug is injected or force applied, needle may enter into artery. When drug is injected forcefully retrograde flow into vessels (artery) occur [8].…”

“…Intra-arterial cannulation can occur in any age group but IA cannulation with penicillin [5] [7] [8] is common in babies. Nowadays, it is increasingly seen in IV drug abusers [3] [9].…”

Do Perinatal Nurses Still Check for Blood Return When Administering the Hepatitis B Vaccine?

“…The other was administered into the infants’ midlateral thigh, although excessive needle length and injecting too low on the leg were reported to have also contributed to that injury (Talbert, Haslam, & Haller, ). The use of the dorsal gluteal as an injection site for infants has been discouraged now for many years (Wynne, Williams, & Ellman, ). More recently the dorsal gluteal has also been discouraged in adults due to the potential for sciatic nerve injury (Small, ; Zimmerman, ), and using this muscle as an injection site is no longer being described as a technique in some nursing fundamentals textbook (Potter & Perry, ; Taylor, Lillis, LeMone, & Lynn, ).…”