Patient Severely Burned By IV Fluid Extravasation

Case Overview

This case is located in Mississippi and involves a 60-year-old male patient who was recovering in a surgical ICU following a surgical procedure. During his ICU admission, the nursing staff caused an extravasation of IV fluid into the patient’s right hand. During the time range of the extravasation, the patient was likely sedated, intubated and restrained. The extravasation was likely a vesicant agent or a high concentration irritant agent, given the degree of tissue damage and necrosis caused. No physician was informed. The nursing staff dressed the wound with gauze, Kerlix and Silver Sulfadiazine. A plastic surgery consult was not requested until weeks later. The wound required multiple surgical debridements and skin grafts.

Questions to the Plastic Surgery expert and their responses

How often do you treat IV extravasation of the hand?

I frequently treat these patients.

What is the protocol for treating this injury?

Once the patient's injury was recognized, he should have been seen by a plastic surgeon immediately.

Can a delay in treatment affect a patient's prognosis?

Given that the patient was likely unconscious when the injury occurred, the responsibility for ensuring the security of his IV line was entirely on the medical staff.

About the expert

This board certified Plastic and Reconstructive Surgery expert is Fellowship trained and highly experienced in his field. He received his medical education form some of the most prestigious institutions in the country. He is a Fellow of the American Society of Plastic Surgery, as well as a member of several professional organizations. He has been awarded multiple honors throughout his career including the Reagen Fellow Award and The American Society of Maxillofacial Surgeons Resident Scholar Award. This expert has published 22 peer-reviewed journal articles and authored two book chapters. He serves as a reviewer for the Journal of Pediatric Surgery and is President of Saving Faces Foundation. He is currently Assistant Professor of Surgery at a major health system and enjoys hospital privileges at seven local hospitals.