Prehospital Dextrose Extravasation Causing Forearm Compartment Syndrome: A Case Report. Prehosp Emerg Care 2017;21(1):79-82
Date
09/07/2016Pubmed ID
27598324DOI
10.1080/10903127.2016.1209263Scopus ID
2-s2.0-84986222833 (requires institutional sign-in at Scopus site) 7 CitationsAbstract
CASE: A 57-year-old woman was found at home by paramedics to be hypoglycemic with altered mental status. She had multiple attempts at IV access and eventually a 22G IV was established and D50 was infused into her right forearm. Extravasation of the dextrose was noted after approximately 12 g of the medication was infused. She was given a dose of glucagon intramuscularly and her mental status improved. Shortly after her arrival to the emergency department, she was noted to have findings of compartment syndrome of her forearm at the site of the dextrose extravasation. She was evaluated by plastic surgery and taken to the operating room for emergent fasciotomy. She recovered well from the operation.
DISCUSSION: D50 is well known to cause phlebitis and local skin necrosis as a complication. This case illustrates the danger of compartment syndrome after D50 extravasation. It is the first documented case of prehospital dextrose extravasation leading to compartment syndrome. There may be safer alternatives to D50 administration and providers must be acutely aware to monitor for D50 infusion complications.
Author List
Chinn M, Colella MRAuthors
Matthew Chinn MD Associate Professor in the Emergency Medicine department at Medical College of WisconsinMario R. Colella DO, MPH Professor in the Emergency Medicine department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Compartment SyndromesEmergency Medical Services
Extravasation of Diagnostic and Therapeutic Materials
Female
Forearm
Forearm Injuries
Glucose Solution, Hypertonic
Humans
Middle Aged