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Prehospital Dextrose Extravasation Causing Forearm Compartment Syndrome: A Case Report
Prehospital Emergency Care
|September 7, 2016
Summary
Prehospital dextrose (D50) extravasation in a hypoglycemic patient led to compartment syndrome, requiring emergent fasciotomy. This case highlights the risks of dextrose extravasation and the need for careful monitoring during infusion.
Area of Science:
- Emergency Medicine
- Surgical Complications
- Prehospital Care
Background:
- Hypoglycemia is a critical condition requiring prompt glucose administration.
- Dextrose 50% (D50) is commonly used intravenously to treat severe hypoglycemia.
- Extravasation of D50 can lead to local tissue damage.
Observation:
- A 57-year-old woman presented with hypoglycemia and altered mental status.
- Intravenous D50 infusion resulted in extravasation into the forearm.
- Compartment syndrome developed at the extravasation site, necessitating fasciotomy.
Findings:
- This is the first documented case of prehospital dextrose extravasation causing compartment syndrome.
- Dextrose extravasation, though known for phlebitis and necrosis, can lead to severe complications like compartment syndrome.
- Prompt surgical intervention (fasciotomy) was required to manage the compartment syndrome.
Implications:
- Healthcare providers must be vigilant about potential complications of D50 extravasation.
- Alternative methods for dextrose administration in prehospital settings may need consideration.
- Early recognition and management of dextrose extravasation are crucial to prevent severe outcomes.
