Prehospital Dextrose Extravasation Causing Forearm Compartment Syndrome: A Case Report

Chinn, Matthew; Colella, M. Riccardo

doi:10.1080/10903127.2016.1209263

Cited by 9 publications

(2 citation statements)

References 11 publications

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“…One of these is extravasation and infiltration damage, which occurs when IV-administered drugs or substances escape from the venous system and leak into the surrounding tissue, an important cause of morbidity in hospitalized patients [ 1 , 4 ]. In the emergency medicine literature on these injuries, vasopressor agents [ 1 , 4 ], high-concentration dextrose solutions [ 3 , 6 , 7 ], radiographic contrast agents [ 2 , 8 , 9 ], peripheral parenteral nutrition [ 10 ], antiarrhythmic and sedative-hypnotics [ 11 , 12 ], and antibiotics [ 1 , 4 ] have been implicated and frequently reported. There have not been any adult cases reported in the literature regarding extravasation injuries and compartment syndrome associated with the use of IV furosemide.…”

Section: Discussionmentioning

confidence: 99%

A case report of furosemide extravasation in the hand: a rare cause of compartment syndrome

Güler¹,

Kocaşaban²

2022

Clin Exp Emerg Med

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In emergency departments, many drugs, fluids, and materials for medical examinations and treatment are typically administered to patients intravenously. One of the most common complications of the intravenous bolus or infusion of drugs is extravasation injuries. These injuries may cause certain morbidities for the patient, increase the cost of treatment, and prolong hospital stays. At the same time, these injuries also carry medicolegal risks for health personnel. Furosemide is a potent diuretic that is commonly used in emergency departments for volume overload conditions. To the best of our knowledge, there have been no cases reported in the literature of furosemide-induced extravasation injury with subsequent compartment syndrome that has required surgical intervention. Presented herein is the case of a 70-year-old female patient who was administered intravenous furosemide from the dorsum of the left hand and whose extravasation injury progressed to compartment syndrome requiring an emergency fasciotomy.

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Section: Discussionmentioning

confidence: 99%

A case report of furosemide extravasation in the hand: a rare cause of compartment syndrome

Güler¹,

Kocaşaban²

2022

Clin Exp Emerg Med

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“…5 The administration of D50 does carry with it an associated risk of extravasation due to its hypertonicity and a risk of supratherapeutic dosing resulting in hyperglycemia and rebound hypoglycemia. 3,4,6,7 Operationally, frequent nationwide shortages of the D50 prefilled syringes and higher medication costs have also contributed to this transition to D10 infusions as well. 8 -10 A recent evidence-based review of the literature for emergency treatment of hypoglycemia concluded that 10 to 25 g of IV dextrose is recommended, with a preference toward D10 over D50 because of a lower risk of posttreatment hyperglycemia and less total glucose administration.…”

Section: Introductionmentioning

confidence: 99%

A Comparison of 10% Dextrose and 50% Dextrose for the Treatment of Hypoglycemia in the Prehospital Setting

Weant

Deloney

Elsey

et al. 2019

Journal of Pharmacy Practice

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Background: Hypoglycemia is a frequent cause of emergency medical services (EMS) activation; however, limited evidence exists to support optimal prehospital treatment. Objective: This study sought to compare the safety and efficacy of the administration of 10% dextrose (D10) intravenously (IV) versus 50% dextrose (D50) IV for the treatment of hypoglycemia in the prehospital setting. Methods: This was a retrospective cohort study of patients who received IV dextrose by EMS and were transported to an academic teaching hospital emergency department between 2014 and 2017. Results: Four hundred seventy-eight eligible patients were reviewed, with 161 patients receiving D10 and 150 patients receiving D50. There was no significant difference found regarding the need for dextrose retreatment prior to hospital arrival between the D10 and D50 groups (0.6% vs 2.0%; P = .565). The prehospital reassessment glucose in the D50 group was a significantly higher than the D10 group (151.9 vs 124.6 mg/dL, P = .001) and this difference was maintained on hospital arrival (129.5 vs 108.0 mg/dL, P = .011). No significant difference was found between groups with regard to hospital admission, length of stay, or in-hospital mortality. Conclusion: When comparing D10 with D50 for the treatment of hypoglycemia by EMS, there were no significant differences in the need for dextrose retreatment prior to hospital arrival. The use of D50 resulted in a significantly higher blood glucose concentrations both in the prehospital setting and upon hospital arrival. Further study is needed in larger patient populations to evaluate the use of D10, the need for dextrose readministration, and its impact on clinical outcomes.

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2017

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Prehospital Dextrose Extravasation Causing Forearm Compartment Syndrome: A Case Report

Cited by 9 publications

References 11 publications

A case report of furosemide extravasation in the hand: a rare cause of compartment syndrome

A case report of furosemide extravasation in the hand: a rare cause of compartment syndrome

A Comparison of 10% Dextrose and 50% Dextrose for the Treatment of Hypoglycemia in the Prehospital Setting

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