A Potent Medication Administered in a Not So Viable Route
A man with a history of cardiac disease was brought to the emergency department for septic shock of possible intra-abdominal origin. A vasopressor was ordered. However, rather than delivering it through a central line, the norepinephrine was infused through a peripheral line. The medication extravasated into the subcutaneous tissue of the patient's arm. Despite attempts to salvage the patient's wrist and fingers, three of his fingertips had to be amputated. In the accompanying commentary, Osama Loubani, MD, of Dalhousie University, reviews challenges to caring for patients with shock resistant to fluid resuscitation and suggests that vasopressors can be safely administered through peripheral IVs as long as clear guidelines are in place and followed.